Premium
Prediabetes and diabetes accelerate cognitive decline and predict microvascular lesions: A population‐based cohort study
Author(s) -
Marseglia Anna,
Fratiglioni Laura,
Kalpouzos Grégoria,
Wang Rui,
Bäckman Lars,
Xu Weili
Publication year - 2019
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.3060
Subject(s) - prediabetes , hyperintensity , diabetes mellitus , cognitive decline , dementia , brain size , medicine , white matter , population , magnetic resonance imaging , psychology , gerontology , endocrinology , type 2 diabetes , radiology , disease , environmental health
The impact of prediabetes and diabetes on cognitive decline and the potential underlying mechanisms remain unclear. We investigated whether prediabetes and diabetes accelerate cognitive decline and brain aging, and the initial pathological changes linked to microvascular processes. Methods Nine‐year longitudinal data from the Swedish National Study on Aging and Care‐Kungsholmen (n = 2746, age ≥60 years) and the magnetic resonance imaging subsample (n = 455) were used. Cognitive function was assessed with Mini‐Mental State Examination. Brain magnetic resonance imaging markers included total brain tissue, white matter, gray matter, white matter hyperintensities, and hippocampal volumes. Results Compared with diabetes‐free status, prediabetes and diabetes were independently associated with accelerated cognitive decline. Prediabetes was cross‐sectionally associated with smaller total brain tissue volume ( P < .01), particularly smaller white matter volume. Diabetes was associated with larger white matter hyperintensities volume. Longitudinally, diabetes was associated with faster white matter hyperintensities accumulation. No associations between prediabetes or diabetes and hippocampal volume were found. Discussion Diabetes and prediabetes accelerate cognitive decline and might predict microvascular lesions among dementia‐free older adults.