Macrovascular disease may increase the risk of accelerated cognitive decline in elderly patients with type 2 diabetes, according to new research published online in Diabetes Care .
The study was conducted by Insa Feinkohl, from the University of Edinburgh, and colleagues in an attempt to determine associations of measures of macrovascular disease (disease of the large blood vessels ) with changes in cognitive ability in older diabetic patients.
The researchers measured signs of macrovascular disease in 831 cognitively healthy men and women with type 2 diabetes aged 60-75 years. These included cardiovascular event history, carotid intima-media thickness (cIMT) and ankle brachial index (ABI).
Each adult underwent seven neuropsychological tests at baseline and after four years, and adjustment for vocabulary (estimated premorbid ability) was used to estimate lifetime cognitive change.
The results showed a significant connection between measures of cognitive decline and stroke, cIMT, ABI and N-terminal probrain natriuretic peptide (NT-proBNP).
They also revealed a statistically significant association between stroke and increased estimated lifetime cognitive decline, and between subclinical markers and actual four-year decline.
“Stroke and subclinical markers of cardiac stress and generalised atherosclerosis are associated with cognitive decline in older patients with type 2 diabetes,” the authors concluded, adding that further research into the potential of subclinical vascular disease markers as indicators of cognitive decline is warranted.

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