Neurology-Diabetes causes cognitive decline, or is driven by neurodegeneration

Type 2 diabetes (diabetes) is a risk factor for cognitive decline and dementia
.

There are several potential mechanisms that may be involved, such as chronic hyperglycemia leading to advanced glycation end products, arteriosclerosis and subsequent cerebrovascular disease

Diabetic blood vessels

Diabetes is also related to changes in brain structure, such as brain atrophy and cerebrovascular disease
.

In addition, although diabetes is related to low brain metabolism, the relationship between it and the pathology of amyloid and tau, whether measured in the brain (PET) or CSF, results in contradictory results

Previous studies have shown that biomarkers of neurodegeneration and small vessel disease mediate the link between diabetes and cognition
.

However, the mediating role of AD specific lesions (amyloid plaques and neurofibrillary tangles) and the correlation between these different brain characteristics have not been considered so far

In this way, Eric Frison and others of the University of Bordeaux, France, used the non-dementia elderly recruited by the French Memory Clinic to evaluate the mediating role of biomarkers of AD, neurodegeneration and small vessel disease in diabetes and cognition
.

Among the non-demented elderly recruited by the French memory clinic, the mediating role of biomarkers of AD, neurodegeneration and small vessel disease in diabetes and cognition was evaluated
.

Among the non-demented elderly recruited by the French memory clinic, the mediating role of biomarkers of AD, neurodegeneration and small vessel disease in diabetes and cognition was evaluated

They used structural equation models to evaluate AD pathology (average PET amyloid uptake, Aβ42/Aβ40 ratio, and CSF phosphorylated tau), SVD (white matter hyperintensity and grade), and neurodegeneration (average cortical thickness, brain parenchymal parts, Whether the latent variables of hippocampus volume and average fluorodeoxyglucose intake mediate the connection between diabetes and cognitive latent variables (five neuropsychological tests), and adjust for potential confounding factors
.

They found that 254 (11.
1%) of the 2288 participants had diabetes (median age 71.
6 years; 61.
8% were women)
.

The association between diabetes and lower cognitive ability is mediated by higher neurodegeneration (standardized indirect effect: -0.
061, 95% confidence interval: -0.
089; -0.
032), but not mediated by SVD and AD markers Guide
.

The association between diabetes and lower cognitive abilities is mediated by higher neurodegeneration.
The association between diabetes and lower cognitive abilities is mediated by higher neurodegeneration.

When considering the latent variables of memory or executive function, the results are similar
.

The significance of this study lies in the discovery that in a large clinical cohort of elderly people, diabetes is associated with lower cognitive ability through neurodegeneration, independent of SVD and AD biomarkers
.

It was found that in a large clinical cohort of elderly people, diabetes was associated with lower cognitive ability through neurodegeneration, independent of SVD and AD biomarkers
.

It was found that in a large clinical cohort of elderly people, diabetes was associated with lower cognitive ability through neurodegeneration, independent of SVD and AD biomarkers

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