Type 2 diabetes accelerates brain aging and cognitive decline-ScienceDaily

The authors evaluated the relationship between typical brain aging and the aging seen in type 2 diabetes, and observed that type 2 diabetes follows a neurodegenerative pattern similar to aging, but progresses faster. One of the key implications of this finding is that even typical brain aging may reflect changes in insulin-induced glucose regulation in the brain.

The results further suggest that by the time type 2 diabetes is officially diagnosed, there may already be significant structural damage to the brain. Therefore, there is an urgent need for sensitive methods for detecting diabetes-related brain changes.

Although there is already strong evidence linking type 2 diabetes to cognitive decline, few patients currently receive a comprehensive cognitive assessment as part of their clinical care. It can be difficult to distinguish between normal brain aging that begins in middle age and brain aging that is caused or accelerated by diabetes. To date, no studies have directly compared the lifelong neurological changes of healthy people with the changes experienced by diabetics of the same age.

“Routine clinical assessments for diagnosing diabetes usually focus on blood glucose, insulin levels, and body weight percentages,” said a PhD student in the Department of Medical Bioengineering at Stony Brook University, New York, USA. One lead author, Botond Antal, said: “But the neurological effects of type 2 diabetes can be revealed years before standard means can be detected, so by the time type 2 diabetes is diagnosed by conventional testing. , The patient may already have an irreversible brain injury. “

To define the effects of diabetes on the brain in addition to normal aging, the team utilized the largest brain structure and functional dataset available throughout human life. UK Biobank data for 20,000 people aged 50-80. This dataset contains brain scans and brain function measurements and holds data for both healthy individuals and individuals diagnosed with type 2 diabetes. They used this to determine which brain and cognitive changes are specific to diabetes, as well as aging, and confirm these results by comparing them with the meta-analyses of nearly 100 other studies. bottom.

According to their analysis, both aging and type 2 diabetes cause changes in executive function such as working memory, learning, and flexible thinking, as well as changes in brain processing speed. However, people with diabetes had an additional 13.1% reduction in executive function beyond the effects of aging, and a further 6.7% reduction in processing speed compared to people of the same age without diabetes. Meta-analyses from other studies have confirmed this finding. People with type 2 diabetes consistently showed significantly lower cognitive abilities compared to healthy individuals of similar education at the same age.

The team also used MRI scans to compare brain structure and activity between people with and without diabetes. Here, they found that gray brain material decreased with age, primarily in areas called the ventral striatum. This is important for executive functioning of the brain. Nevertheless, diabetics had an even more pronounced reduction in gray matter beyond the typical aging effects. Compared to normal aging, the gray matter of the ventral striatum was further reduced by 6.2%, but in other areas the gray matter was reduced.

Taken together, the results suggest that the pattern of type 2 diabetes-related neurodegeneration strongly overlaps with the pattern of normal aging, but that neurodegeneration is accelerating. In addition, these effects on brain function became more severe as the duration of diabetes increased. In fact, the progression of diabetes was associated with a 26% acceleration of brain aging.

“Our findings suggest that type 2 diabetes and its progression may be associated with accelerated brain aging, which impairs energy availability and in the brain. This is because of the potential for major changes in structure and function, “concludes Lilianne Musica Parody, senior author and director of the Institute for Computational Neurodiagnosis. , Stony Brook University. “By the time diabetes is officially diagnosed, this damage may have already occurred. However, brain imaging is clinical to identify and monitor these neurocognitive effects associated with diabetes. May provide valuable indicators for diabetes and treatment strategies specifically targeting its neurocognitive effects. “

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