Increased cortical atrophy in patients with Alzheimer's disease and type 2 diabetes mellitus. Issue 3 (16th February 2006)

• Record Type: Journal Article
• Authors: Biessels, G J; De Leeuw, F-E; Lindeboom, J; Barkhof, F; Scheltens, P
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 77:Issue 3(2006)
• Page Start: 304
• Page End: 307
• Publication Date: 2006-02-16
• Subjects: AD, Alzheimer's disease -- CT, computed tomography -- DM2, diabetes mellitus type 2 -- MMSE, Mini-Mental State Examination -- MRI, magnetic resonance imaging -- WML, white matter lesions; type 2 diabetes mellitus -- dementia -- Alzheimer's disease -- cortical atrophy; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.2005.069583
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: The risk of Alzheimer's disease (AD) is increased in type 2 diabetes (DM2). This increased risk has been attributed to vascular comorbidity, but other mechanisms, such as accelerated ageing of the brain, have also been implicated. Objective: To determine whether AD in patients with DM2 is associated with an increased occurrence of vascular lesions in the brain, by increased cerebral atrophy, or a combination of both. Methods: In total, 29 patients with AD and DM2 and 58 patients with AD and without DM2 were included in the study. Clinical characteristics were recorded, and a neuropsychological examination and magnetic resonance imaging (MRI) scan were performed. MRI scans were rated for cortical and subcortical atrophy, medial temporal lobe atrophy, white matter lesions, and infarcts. Results: The neuropsychological profiles of the two groups were identical. Patients with AD and DM2 had increased cortical atrophy on MRI (p<0.05) compared with the non-DM2 group. In addition, infarcts were more common (odds ratio 2.4; 95% CI 0.8 to 7.8), but this effect did not account for the increased atrophy. The other MR measures did not differ between the groups. Conclusion: The results suggest that non-vascular mechanisms, leading to increased cortical atrophy, are also involved in the increased risk of AD in DM2.