Diabetes
A risk factor for cognitive impairment and dementia?
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Hyperglycemia, caused by impaired insulin sensitivity or secretion, is the hallmark of diabetes. In epidemiologic studies, diabetes has been related to cognitive impairment and both vascular and neurodegenerative forms of dementia.1 As diabetes and dementia are more common at older ages, it is possible that their association is attributable to common causes. It is also possible that type 2 diabetes affects cognitive function only at older ages when the brain undergoes neurodegenerative changes associated with ageing.2 In this issue of Neurology®, data from the Framingham Heart Study show diabetes to be associated with subtle brain injury and poor performance on tests of memory, visual perception, and attention.3 Although fasting glucose was not associated with performance on cognitive tests, it was associated with gray matter atrophy and reduced white matter integrity. These results are striking because the mean age of participants was 40 years at the glycemic assessment and 47 years at cognitive assessment and brain imaging. Recent studies have also reported accelerated cognitive decline in middle-aged adults with longer exposure to type 2 diabetes.4,5 These results, considered together, suggest that the diabetes-cognition association is not confined to old age.
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Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.
See page 2329
- © 2015 American Academy of Neurology
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