Type 2 diabetes mellitus, brain atrophy, and cognitive decline

Chris Moran; Richard Beare; Wei Wang; Michele Callisaya; Velandai Srikanth; Alzheimer's Disease Neuroimaging Initiative (ADNI)

doi:10.1212/WNL.0000000000006955

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Type 2 diabetes mellitus, brain atrophy, and cognitive decline

Journal article

Open access

Peer reviewed

Type 2 diabetes mellitus, brain atrophy, and cognitive decline

Chris Moran, Richard Beare, Wei Wang, Michele Callisaya, Velandai Srikanth and Alzheimer's Disease Neuroimaging Initiative (ADNI)

Neurology, Vol.92(8), pp.e823-e830

02/19/2019

DOI: 10.1212/WNL.0000000000006955

PMCID: PMC7987953

PMID: 30674592

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https://www.ncbi.nlm.nih.gov/pmc/articles/7987953View

Open Access

Abstract

To study longitudinal relationships between type 2 diabetes mellitus (T2DM), cortical thickness, and cognitive function in older people with normal cognition, mild cognitive impairment, and Alzheimer disease (AD). The sample was derived from the Alzheimer's Disease Neuroimaging Initiative cohort who underwent brain MRI and cognitive tests annually for 5 years. Presence of T2DM was based on fasting blood glucose ≥7.0mml/L or the use of glucose-lowering agents. We used latent growth curve modeling to explore longitudinal relationships between T2DM, cortical thickness, and cognitive function, adjusting for relevant covariates and testing for interactions. There were 124 people with T2DM (mean age 75.5 years, SD 6.2) and 693 without T2DM (mean age 75.1 years, SD 6.9) with at least 1 MRI available. AD and lower cortical thickness at study entry was associated with a lower chance of having a MRI available at each follow-up phase (all < 0.001). T2DM was associated with lower baseline cortical thickness ( = 0.01). We found no direct effect of T2DM on decline in cortical thickness or cognitive function, but there was an indirect pathway linking T2DM and cognitive decline via baseline cortical thickness (β = -0.17, = 0.022). There was an interaction between T2DM and education whereby the negative effect of T2DM on baseline cortical thickness was reduced in those with greater education (β = 0.34, = 0.037). These associations changed minimally when adjusted for baseline cognitive diagnosis. In an older cohort with low cerebrovascular disease burden, T2DM contributes to cognitive decline via neurodegeneration. Prior brain and cognitive reserve may protect against this effect.

Magnetic Resonance Imaging

Brain - diagnostic imaging

Humans

Cerebral Cortex - pathology

Organ Size

Male

Factor Analysis, Statistical

Diabetes Mellitus, Type 2 - metabolism

Cerebral Cortex - diagnostic imaging

Diabetes Mellitus, Type 2 - epidemiology

Atrophy - epidemiology

Cognitive Dysfunction - epidemiology

Aged, 80 and over

Brain - pathology

Alzheimer Disease - epidemiology

Female

Aged

Alzheimer Disease - diagnostic imaging

Blood Glucose - metabolism

Cognitive Dysfunction - diagnostic imaging

Longitudinal Studies

Details

Title: Subtitle: Type 2 diabetes mellitus, brain atrophy, and cognitive decline
Creators: Chris Moran - From the Department of Medicine (C.M., R.B., W.W., M.C., V.S.), Peninsula Clinical School, Central Clinical School, Monash University; Departments of Medicine and Geriatric Medicine (C.M., V.S.), Peninsula Health; Department of Aged Care (C.M.), Caulfield Hospital, Alfred Health; Developmental Imaging (R.B.), Murdoch Children's Research Institute, Melbourne; and Menzies Institute for Medical Research (M.C., V.S.), University of Tasmania, Hobart, Australia. chris.moran@monash.edu
Richard Beare - From the Department of Medicine (C.M., R.B., W.W., M.C., V.S.), Peninsula Clinical School, Central Clinical School, Monash University; Departments of Medicine and Geriatric Medicine (C.M., V.S.), Peninsula Health; Department of Aged Care (C.M.), Caulfield Hospital, Alfred Health; Developmental Imaging (R.B.), Murdoch Children's Research Institute, Melbourne; and Menzies Institute for Medical Research (M.C., V.S.), University of Tasmania, Hobart, Australia
Wei Wang - From the Department of Medicine (C.M., R.B., W.W., M.C., V.S.), Peninsula Clinical School, Central Clinical School, Monash University; Departments of Medicine and Geriatric Medicine (C.M., V.S.), Peninsula Health; Department of Aged Care (C.M.), Caulfield Hospital, Alfred Health; Developmental Imaging (R.B.), Murdoch Children's Research Institute, Melbourne; and Menzies Institute for Medical Research (M.C., V.S.), University of Tasmania, Hobart, Australia
Michele Callisaya - From the Department of Medicine (C.M., R.B., W.W., M.C., V.S.), Peninsula Clinical School, Central Clinical School, Monash University; Departments of Medicine and Geriatric Medicine (C.M., V.S.), Peninsula Health; Department of Aged Care (C.M.), Caulfield Hospital, Alfred Health; Developmental Imaging (R.B.), Murdoch Children's Research Institute, Melbourne; and Menzies Institute for Medical Research (M.C., V.S.), University of Tasmania, Hobart, Australia
Velandai Srikanth - From the Department of Medicine (C.M., R.B., W.W., M.C., V.S.), Peninsula Clinical School, Central Clinical School, Monash University; Departments of Medicine and Geriatric Medicine (C.M., V.S.), Peninsula Health; Department of Aged Care (C.M.), Caulfield Hospital, Alfred Health; Developmental Imaging (R.B.), Murdoch Children's Research Institute, Melbourne; and Menzies Institute for Medical Research (M.C., V.S.), University of Tasmania, Hobart, Australia
Alzheimer's Disease Neuroimaging Initiative (ADNI)
Contributors: Laura L Boles-Ponto (Contributor) - University of Iowa, Radiology
Resource Type: Journal article
Publication Details: Neurology, Vol.92(8), pp.e823-e830
DOI: 10.1212/WNL.0000000000006955
PMID: 30674592
PMCID: PMC7987953
NLM abbreviation: Neurology
ISSN: 0028-3878
eISSN: 1526-632X
Publisher: United States
Grant note: P30 AG010133 / NIA NIH HHS R01 AG019771 / NIA NIH HHS
Language: English
Date published: 02/19/2019
Academic Unit: Radiology; Pharmaceutical Sciences and Experimental Therapeutics
Record Identifier: 9984051721202771

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