MR highlights diabetes risk factor for Alzheimer's disease
MR imaging shows that diabetic patients face a high likelihood of developing cortical atrophy, according to an international multicenter study published in the March issue of Diabetes.
Investigators in the Cardiovascular Determinants of Dementia (CASCADE) Study randomly selected 1805 individuals aged 65 to 75 from eight European countries. Two-thirds were diabetic patients with measured fasting and nonfasting glucose levels, who were undergoing treatment at the time of the study.
The researchers found that MR confirmed more extensive cortical atrophy and a higher ventricle-to-brain ratio in the patients with diabetes.
After adjusting for sex, age, education, and cardiovascular disease risk factors, they found a nonsignificant increase in risk of cortical atrophy among diabetic patients compared with nondiabetic subjects. Hypertensive diabetic patients, however, showed a statistically significant risk of cortical atrophy.
Although diabetic patients face a high stroke risk, little is known about other possible brain or vascular lesions. The CASCADE findings are in line with several recent epidemiological and pathological studies showing that diabetes and hypertension are risk factors for cerebrovascular disease and Alzheimer's disease, said principal investigator Dr. Reinhold Schmidt, an associate professor of neurology at the Medical University of Graz, Austria.
The interaction of diabetes and hypertension on brain atrophy was seen as a possible marker of degenerative brain disease. The CASCADE findings may have important preventive implications, considering the high incidence of these two risk factors in the general population, he said.
The treatment of diabetes -- particularly in hypertensive patients -- could prevent or at least slow primary degenerative brain changes and their unfavorable consequences, including cognitive impairment in the elderly, Reinhold said.
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