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With cardiovascular disease and diabetes may come increased risk of cognitive decline

Winston-Salem Journal (NC)


July 01--If it's not bad enough for individuals to experience both cardiovascular disease and type 2 diabetes, Wake Forest Baptist Medical Center researchers have determined they are at increased risk for a third ailment -- cognitive decline.

"There has been a lot of research looking at the links between type 2 diabetes and increased risk for dementia, but this is the first study to look specifically at cardiovascular disease and the role it plays," said Christina Hugenschmidt, an instructor of gerontology and geriatric medicine at Wake Forest Baptist. "Our research shows that cardiovascular disease risk caused by diabetes, even before it's at a clinically treatable level, might be bad for your brain."

According to the American Heart Association, type 2 diabetes contributes to cardiovascular disease risk by elevating blood pressure and blood sugar levels, which can lead to obesity and unhealthy cholesterol levels.

Wake Forest Baptist researchers found that cardiovascular disease factors, such as calcified plaque and vascular status, are major contributors to type 2 diabetes-related cognitive decline. As such, cardiovascular disease explains a lot of the cognitive problems that people with diabetes experience, Hugenschmidt said.

"One possibility is that your brain requires a really steady blood flow, and the cardiovascular disease that accompanies diabetes might be the main driver behind the cognitive deficits that we see," she said.

The research represents a spinoff from a diabetes heart study, which investigated cardiovascular disease in siblings with a high incidence and prevalence of type 2 diabetes from 1998 to 2006. There were 1,443 participants in the earlier study.

The latest research added cognitive testing to existing measures with the express purpose of exploring the relationships between measures of atherosclerosis and cognition in a population heavily affected by diabetes. Of the 516 participants in the earlier study who had cardiovascular issues, 422 were affected with type 2 diabetes.

Having siblings involved in the studies made the results more clinically relevant, Hugenschmidt said, because they shared the same environmental and genetic background.

Researchers primarily studied the participants' memory and processing speed, as well as executive function, which deal with stop-and-think processes, such as managing time and attention, planning and organizing.

"Even compared to their own siblings who were not disease free, those with diabetes and subclinical cardiovascular disease had a higher risk of cognitive dysfunction," Hugenschmidt said.

The study is being published in the Journal of Diabetes and Its Complications and is supported by funds from the National Institutes of Health.

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