Abstract
Background and aims
Both vascular disease and diabetes type 2 (DM2) decrease cognitive functioning in
elderly people. It is uncertain if DM2 affects cognition independent of vascular disease.
In patients with symptomatic arterial disease, we studied the effect of DM2 on cognition
and identified clinical and radiological determinants for impaired cognition in patients
with DM2.
Methods
766 patients (mean age 58.8±9.5 years; 108 DM2) with symptomatic arterial disease underwent neuropsychological
testing. In 542 patients (77 DM2), volumes of brain tissue, ventricles and white matter
lesions were obtained by segmentation of brain MR images. Infarcts were distinguished
into small (lacunar) or large (cortical or subcortical).
Results
Patients with arterial disease and DM2 performed worse on neuropsychological tests
compared to similar patients without DM2 (adjusted composite z-score: β −0.14 [−0.25 to −0.02]). Insulin treatment, systolic and diastolic blood pressures were significantly
associated with cognition in patients with DM2. Large infarcts, global and cortical
atrophy on MRI were independently associated with cognition in patients with DM2.
Conclusion
The presence of DM2 in patients with symptomatic arterial disease is associated with
decreased cognitive functioning. Insulin treatment, high blood pressure, brain atrophy
and large infarcts were determinants for cognitive dysfunction in patients with DM2
and arterial disease.
Keywords
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Article info
Publication history
Published online: March 09, 2009
Footnotes
☆Disclosure: The authors report no conflicts of interest.
Identification
Copyright
© 2009 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
