Type 2 Diabetes Tied to Brain Atrophy in the Elderly

In the May issue of Diabetes Care, Dr. Novak, of Beth Israel Deaconess Medical Center, Boston and colleagues hypothesize that the condition might be associated with microvascular disease. To investigate, they studied 26 diabetics, mean age of 61.6 years, and 25 comparable controls.

The diabetic group had significantly smaller global white and gray matter and larger cerebrospinal fluid (CSF) volumes than controls.

This was also true of white matter and CSF in the frontal region, of CSF in the temporal region, and of gray matter and CSF in the parieto-occipital region.

In addition, diabetes was associated with significantly reduced regional cerebral blood flow and CO2 reactivity. Hypoperfusion in the frontal region was significantly associated with gray matter atrophy, and higher glycosylated hemoglobin was associated with significantly lower cerebral blood flow and greater CSF within the temporal region.

The researchers note that uncontrolled diabetes may contribute to such problems. "These findings may have clinical implications for development of cognitive impairment, executive dysfunction and balance problems in people with diabetes," Dr. Novak said.

"New preventive and therapeutic strategies improving vascular reactivity and preventing brain atrophy are needed," she concluded.

Diabetes Care 2007;30:1193-1199.

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