Diabetes, Amyloid Pathology Linked With Progression to MCI Over 20 Years
Type 2 diabetes and an abnormal amyloid-β concentration in cerebrospinal fluid were associated with accelerated brain atrophy and an earlier progression to mild cognitive impairment (MCI) in a cohort study of middle-aged and older adults with normal cognition at baseline. Researchers published their study findings in JAMA Network Open.
“These results support the importance of identifying individuals who have accelerated brain atrophy to optimize preventive strategies for progression to MCI,” wrote corresponding author Kenichi Oishi, MD, PhD, of the Johns Hopkins University School of Medicine, Baltimore, Maryland, and study coauthors.
The study included 185 participants from the Biomarkers for Older Controls at Risk for Dementia cohort with structural magnetic resonance imaging (MRI) scans of the brain and data on cerebrospinal fluid (CSF) measures for at least 10 years. Researchers investigated various risk factors linked with accelerated brain atrophy and progression from normal cognition to MCI over a mean 20.2 years of follow up.
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Over follow up, approximately a third of participants progressed to MCI, according to the study. Eight participants went on to develop dementia after MCI onset.
Participants with high levels of atrophy in the white matter and ventricle enlargement progressed from normal cognition to MCI symptom onset earlier, the study found. Hazard ratios for earlier progression were 1.86 for those with high rates of white matter atrophy and 1.71 for those with enlargement of ventricles.
“These findings highlight that white matter volume changes are closely associated with cognitive function in aging,” researchers wrote, “suggesting that white matter degeneration may play a crucial role in cognitive decline.”
Additionally, hazard ratios for progression to MCI were 1.41 for adults with diabetes and 1.48 for those with a low CSF amyloid β peptide 42:40 ratio. The combination of the 2 factors was associated with an even higher hazard ratio of 1.55, “indicating,” researchers wrote, “a synergic association of diabetes and amyloid pathology with MCI progression.”
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