June 5, 2013
Risk Of Cognitive Decline Higher In Those With Diabetes, Heart Disease
redOrbit Staff & Wire Reports - Your Universe Online
Patients who suffer from cardiovascular disease (CVD) and Type 2 diabetes also face an increased risk of cognitive decline, according to new research scheduled for publication in the Journal of Diabetes and Its Complications.According to Christina E. Hugenschmidt, lead author of the study and a professor of gerontology and geriatric medicine at Wake Forest Baptist Medical Center, the results of the institute´s Diabetes Heart Study-Mind (DHS-Mind) suggests that heart health is a factor in reasoning and comprehension issues before those signs become clinically apparent in patients.
“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 in a statement Tuesday.
“The results imply that additional CVD factors, especially calcified plaque and vascular status, and not diabetes status alone, are major contributors to type 2 diabetes related cognitive decline,” she added.
DHS-Mind is a follow-up to the Diabetes Hearty Study (DHS), which the researchers said examined the relationships between mental function, vascular calcified plaque and other major diabetes risk factors associated with cognition.
DHS looked at cardiovascular disease in siblings with a high incidence and prevalence of Type 2 diabetes, where extensive measurements of heart disease risk factors were obtained during examinations conducted between the years of 1998 and 2006. That study was supported by the National Institutes of Health (NIH).
The new study added cognitive testing to existing measures, so that the researchers could explore the associations between measures of atherosclerosis and cognition in a population that was heavily impacted by diabetes.
According to Hugenschmidt, this was a novel approach, as previous studies had focused only on diabetes and cognition in the context of clinically evident cardiovascular disease. They followed-up with 516 of the original 1,443 DHS study participants, and found that 422 had been affected by Type 2 diabetes.
Hugenschmidt and her colleagues ran the study participants through “a battery of cognitive testing that looked at different kinds of thinking like memory and processing speed, as well as executive function, which is a set of mental skills coordinated in the brain's frontal lobe that includes stop and think processes like managing time and attention, planning and organizing,” the university explained.
“She said that being able to look at data where the comparison group was siblings, some of whom had a high level of CVD themselves, made the results more clinically relevant because the participants shared the same environmental and genetic background,” they added.
The professor said that her team discovered a difference between the two groups — even when compared to siblings who were not disease free, patients with both diabetes and subclinical cardiovascular disease faced an increased risk of cognitive dysfunction.
One possible reason for this phenomenon, Hugenschmidt explained, “is that your brain requires a really steady blood flow and it's possible that the cardiovascular disease that accompanies diabetes might be the main driver behind the cognitive deficits that we see.”