Document Detail


Microvascular determinants of cognitive decline and brain volume change in elderly patients with type 2 diabetes.
MedLine Citation:
PMID:  20962529     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background/Aims: The present study examined the relationship between microvascular complications and cognitive decline and the development of structural brain abnormalities over a period of 4 years in patients with type 2 diabetes mellitus (T2DM). Methods: Sixty-eight elderly patients with T2DM had 2 cognitive assessments with a 4-year interval. Two MRI scans, performed at the same time as the cognitive assessments, were available from 55 patients. Changes in cognitive performance over time were expressed as a regression-based index (RBI). Automated volumetric measurements of total brain, lateral ventricles and white matter hyperintensities were performed. The relationship between baseline microvascular complications [diabetic retinopathy, peripheral neuropathy or albuminuria (micro- or macroalbuminuria)] and cognition and brain volumes was examined with linear regression analyses adjusted for age and sex (for cognition also for IQ). Results: At baseline, diabetic retinopathy was present in 18% of patients, peripheral neuropathy in 36%, albuminuria in 15%. Retinopathy or neuropathy were not significantly associated with baseline cognition or brain volumes, or changes in these measures over time. Albuminuria was associated with a lower composite RBI score, indicating accelerated cognitive decline (adjusted mean difference between patients with or without albuminuria: -0.58, 95% CI -0.85 to -0.31, p < 0.001). Conclusion: Albuminuria predicted accelerated cognitive decline in patients with T2DM, but other microvascular complications were unrelated to accelerated cognitive decline or brain MRI abnormalities.
Authors:
Jeroen de Bresser; Yael D Reijmer; Esther van den Berg; Marja A Breedijk; L Jaap Kappelle; Max A Viergever; Geert Jan Biessels
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Publication Detail:
Type:  Journal Article     Date:  2010-10-21
Journal Detail:
Title:  Dementia and geriatric cognitive disorders     Volume:  30     ISSN:  1421-9824     ISO Abbreviation:  Dement Geriatr Cogn Disord     Publication Date:  2010  
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9705200     Medline TA:  Dement Geriatr Cogn Disord     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  381-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 S. Karger AG, Basel.
Affiliation:
Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
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