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Cognitive Decline Higher with CVD and Type 2 Diabetes

CVD may be playing a role in cognition problems before it is clinically apparent in patients…. 

Lead author Christina E. Hugenschmidt, Ph.D., an instructor of gerontology and geriatric medicine at Wake Forest Baptist, said, "There has been a lot of research looking at the links between type 2 diabetes and increased risk for dementia, but this is the first study to look specifically at subclinical CVD and the role it plays." "Our research shows that CVD risk caused by diabetes even before it’s at a clinically treatable level might be bad for your brain."

Hugenschmidt said Diabetes Heart Study-Mind (DHS-Mind) is a follow-up study to the Diabetes Heart Study (DHS), which examined relationships between cognitive function, vascular calcified plaque and other major diabetes risk factors associated with cognition. The DHS investigated CVD in siblings with a high incidence and prevalence of type 2 diabetes, where extensive measurements of CVD risk factors were obtained during exams that occurred from 1998 to 2006.

The DHS-Mind study added cognitive testing to existing measures to explore relationships between measures of atherosclerosis and cognition in a population heavily affected by diabetes, a novel approach given that previous studies have focused on diabetes and cognition in the context of clinically evident CVD, Hugenschmidt said. The researchers followed up with as many of the original 1,443 DHS study participants as possible who had cardiovascular measures. Of that 516 total, 422 were affected with type 2 diabetes and 94 were unaffected.

When comparing the group of siblings with both cardiovascular disease and type 2 diabetes, researchers found an increased risk of cognitive decline. A possible explanation for why this may occur is that the brain is a highly complex organ that requires a sufficient, ample amount of blood flow, which may be reduced in the presence of cardiovascular disease and diabetes. As a result, cognitive deficits may be seen.

Journal of Diabetes and Its Complications, June 2013