Losing Your Memory? Diabetes May Be to Blame

Diabetes development in middle age can lead to significant reductions in brain volume, leading to decreases in cognitive performance later in life.

Interestingly, onset of diabetes after age 64 had no impact on cognitive performance or brain volume, suggesting that decades are required for significant changes to occur.
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In order to further investigate the relationship between middle-age-onset diabetes and hypertension and ischemic lesions in the brain, researchers followed 1437 participants (average age of 80) in the Mayo Clinic Study on Aging, a prospective study that began in 2004 to explore risk of cognitive impairment. Participants had either no memory problems or mild cognitive impairment.

Participants underwent neuropsychological testing and MRI to determine brain volume and the presence of cortical infarctions.

Of the participants, 72 developed diabetes during mid-life and 142 during old age, while the remaining 1192 did not develop the disease.

Those that developed the disease during middle age had a 2.9% smaller average total brain volume than other participants. Their hippocampus, the section of the brain associated with memory, was 4% smaller, on average.

They also had a 2-fold increase in risk of mild-cognitive impairment.

During the study, 449 participants developed hypertension at middle age, and 448 developed it later in life.

Midlife hypertension was associated with increased presence of infarctions and lessened whole brain volume, as well as marginally reduced cognitive performance.

"The potential clinical implications of our findings are that the prevention and control of diabetes and hypertension may prevent or delay the ischemic injury and brain neurodegeneration and the onset of clinical manifestation of cognitive impairment," researchers concluded.

–Michael Potts

Roberts R, Knopman D, Przybelski S, et al. Association of type 2 diabetes with brain atrophy and cognitive impairment. Published online before print March 19, 2014, Neurology,doi: 10.1212/WNL.0000000000000269