May 5, 2015

Accelerated Brain Aging in Type 1 Diabetes Related to Cognitive Complications

PITTSBURGH, Pa -- May 5 2015 -- The brains of people with type 1 diabetes show signs of accelerated aging that correlate with slower information processing, according to a study published early online in Neurology.

The findings indicate that clinicians should consider screening middle-aged patients with type 1 diabetes for cognitive difficulties. If progressive, these changes could influence their ability to manage their diabetes.

“The severity of cognitive complications and cerebral small vessel disease -- which can starve the brain of oxygen -- is much more intense than we expected, but it can be measured in a clinical setting,” said senior author Caterina Rosano, MD, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.

“Further study in younger patients is needed, but it stands to reason that early detection and intervention -- such as controlling cardio-metabolic factors and tighter glycaemic control, which help prevent microvascular complications, and could also reduce or delay these cognitive complications,” she added.

For the study, the researchers examined brain magnetic resonance imaging (MRI) cognitive assessments, physical exams, and medical histories of 97 patients with type 1 diabetes participating in the Pittsburgh Epidemiology of Diabetes Complications Study and 81 controls without diabetes.

The ongoing Pittsburgh Epidemiology of Diabetes Complications Study is documenting the long-term complications of type 1 diabetes among patients diagnosed at Children's Hospital of Pittsburgh between 1950 and 1980.

The MRIs showed that 33% of the patients with diabetes had moderate to severe levels of white matter hyperintensities compared with 7% of their non-diabetic counterparts.

On 3 cognitive tests that measure abilities such as information-processing speed, manual dexterity, and verbal intelligence, patients with diabetes averaged lower scores than those without the condition.

Among patients with diabetes, those with greater volumes of white matter hyperintensities averaged lower cognitive scores than those with smaller volumes, though the difference was less pronounced.

The associations held even when the researchers adjusted for high blood pressure and glucose control.

The study identified signs of nerve damage, such as numbness or tingling in extremities, as a risk factor for greater volumes of white matter hyperintensities.

“People with type 1 diabetes are living longer than ever before, and the incidence of type 1 diabetes is increasing annually,” said lead author Karen A. Nunley, PhD, University of Pittsburgh. “We must learn more about the impact of this disease as patients age. Long-term studies are needed to better detect potential issues and determine what interventions may reduce or prevent accelerated brain aging and cognitive decline.”

SOURCE: University of Pittsburgh Schools of the Health Sciences
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