Midlife diabetes, HTN linked to cognitive decline

HealthDay News — Midlife onset of diabetes and hypertension each may contribute to cognitive impairment later in life, according to research published online in Neurology.

Rosebud O. Roberts, MB, ChB, of the Mayo Clinic in Rochester, Minn., and colleagues reviewed medical records and conducted neuropsychological testing and magnetic resonance imaging for 1,437 participants (median age, 80 years) in a population-based cohort without dementia.

The researchers then investigated the associations between diabetes and hypertension with cognition and imaging biomarkers of brain pathology.

Participants with midlife diabetes were more likely to have subcortical infarctions (odds ratio, 1.85; 95% CI: 1.09-3.15; P=0.02), reduced hippocampal volume (−4 percent; 95% CI: −7 to −1.0 percent; P=0.01), reduced whole brain volume (−2.9 percent; 95% CI: −4.1 to −1.6 percent) and prevalent mild cognitive impairment (OR, 2.08; P=0.01).

Midlife hypertension was linked with infarctions and white matter hyperintensity volume and was marginally associated with decreased performance in executive function. Similar associations were not observed with participants who had late-life diabetes or hypertension onset.

“Midlife onset of diabetes may affect late-life cognition through loss of brain volume. Midlife hypertension may affect executive function through ischemic pathology,” the researchers wrote. “Late-life onset of these conditions had fewer effects on brain pathology and cognition.”