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Over the last 2 decades, it has become increasingly recognized that people with type 2 diabetes mellitus (T2DM) have a higher prevalence and incidence of cognitive disorders as compared to people without T2DM. Depending on the tests used for measuring cognition and the severity and duration of T2DM, the incidence of cognitive impairment may be increased by 20%–100%.1 Subtle changes in executive function are the first impairments to be noted, followed by the development of mild cognitive impairment and dementia. How these cognitive deficits develop and progress, and what factors underlie their development, is an area of research interest. Metabolic, inflammatory, and microvascular changes likely play important roles, though it has been difficult to parse out their individual contributions since they often coexist.2 The recent widespread use of brain MRI in large clinical studies has shown that increased amounts of brain atrophy, periventricular white matter hyperintensities, and subclinical infarcts are additional important factors to be considered in people with cognitive impairment.3
Footnotes
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 1681
- © 2016 American Academy of Neurology
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