Cognitive dysfunction profile and arterial stiffness in type 2 diabetes

• Published in: Journal of the neurological sciences 2012-11, Vol.322 (1), p.152-156
• Main Authors: Mehrabian, Shima, Raycheva, Margarita, Gateva, Antoaneta, Todorova, Gergana, Angelova, Petia, Traykova, Martina, Stankova, Tonya, Kamenov, Zdravko, Traykov, Latchezar
• Format: Article
• Language: English
• Subjects: Aged; Analysis of Variance; Arterial stiffness; Attention - physiology; Blood Flow Velocity - physiology; Blood Pressure - physiology; Carotid Arteries - pathology; Carotid Arteries - physiopathology; Cognition Disorders - etiology; Cognitive profile; Diabetes Mellitus, Type 2 - complications; Executive Function - physiology; Female; Humans; Indexing in process; Language; Male; Mental Recall; Mental Status Schedule; Middle Aged; Mild cognitive impairment; Neurology; Neuropsychological Tests; Pulsatile Flow; Pulse wave velocity; Type 2 diabetes; Vascular risk factors; Vascular Stiffness
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2012.07.046

Abstract Background The causative mechanisms of type 2 diabetes (T2D) on cognitive dysfunction are still undergoing development. Aim To explore the cognitive dysfunction profile and its relation to the potential role of arterial stiffness in later middle age T2D patients. Methods We studied 37 patients with T2D (age range 45–65 years) and 22 normal controls. All participants underwent comprehensive neuropsychological assessment. The carotid-femoral pulse wave velocity (CF-PWV) measurements were taken with the PulsePen device. Results Our results showed significantly poorer performance on all tests assessing attention/executive functions and processing speed in patients with T2D. In addition to cognitive slowing T2D patients demonstrated significant deficits in almost all measures of verbal episodic memory after adjustment for age, education and blood pressure (BP) levels (p < 0.05). Carotid-femoral pulse wave velocity (CF-PWV) appeared significantly higher in T2D subjects than in normal controls after adjustment for age and BP level (p < 0.001). Significant relationship was observed between CF-PWV and cognitive status. Conclusion We revealed that arterial stiffness was increased and associated with cognitive impairment in T2D. The cognitive profile indicates hippocampal amnestic type mild cognitive impairment associated with a pronounced dysexecutive syndrome suggesting that diabetes may affect cognition through both vascular and neurodegenerative processes. However, neurodegenerative cognitive profile caused by hippocampal atrophy in a pure vascular process could not be excluded.