How does heart disease affect cognition and brain structural integrity in diabetes?

Conditions

None listed

Brief summary

Type 2 diabetes mellitus and dementia are two of the commonest and most disabling conditions worldwide, responsible for an enormous and growing burden of disease. There is increasing awareness that the two conditions are linked, with cognitive impairment (worsening memory, thinking, perception) common in patients type 2 diabetes, and a strong association between type 2 diabetes and Alzheimer’s disease, the most common form of dementia. Better markers are needed for the prediction of cognitive decline in people with diabetes. Left ventricular hypertrophy (LVH) is an enlargement and thickening (hypertrophy) of the walls of the hearts main pumping chamber, which is common in type 2 diabetes. To date there have been no studies on the association between LVH and cognitive decline in type 2 diabetes. The purpose of this study is to establish whether people with type 2 diabetes and LVH have increased rates of brain volume changes and cognitive impairment. An understanding of whether LVH is contributing to cognitive decline will allow us to identify patients at particular risk.

Sheila K. Patel, Carolina Restrepo, Mohamed Salah Khlif, Emilio Werden, Jay Ramchand et al. (10 authors)

Journal of Hypertension2023-01-01

10.1097/01.hjh.0000913816.61682.a5

Does left ventricular hypertrophy affect cognition and brain structural integrity in type 2 diabetes? Study design and rationale of the Diabetes and Dementia (D2) study.

Patel SK, Restrepo C, Werden E, Churilov L, Ekinci EI, Srivastava PM, Ramchand J, Wai B, Chambers B, O'Callaghan CJ, Darby D, Hachinski V, Cumming T, Donnan G, Burrell LM, Brodtmann A.

2017-04-071 citations

10.1186/s12902-017-0173-7

Interventions

This is a single center observational longitudinal case control study that will follow 168 adult patients aged >50 years with type 2 diabetes mellitus, 50% with left ventricular hypertophy (LVH, case) and 50% without LVH (control). Baseline testing will include: demographic and medical history questionnaire, measurement of height, weight, waist and hip, echocardiogram, ECG, carotid ultrasound, 24 hour ambulatory blood pressure monitor, cognitive assessment, magnetic resonance imaging (MRI), phy

This is a single center observational longitudinal case control study that will follow 168 adult patients aged >50 years with type 2 diabetes mellitus, 50% with left ventricular hypertophy (LVH, case) and 50% without LVH (control). Baseline testing will include: demographic and medical history questionnaire, measurement of height, weight, waist and hip, echocardiogram, ECG, carotid ultrasound, 24 hour ambulatory blood pressure monitor, cognitive assessment, magnetic resonance imaging (MRI), physical activity monitor and a blood sample (to determine HbA1c level, APOE genetic risk assessment). Participants will return for tests at the 2 year time-point.

Eligibility

Sex/Gender

All

Age

50 Years to No maximum

Healthy volunteers

No

Inclusion criteria

1. Diagnosed with type 2 diabetes 2. Aged over 50 years 3. Able to attend 2 study sessions 2 years apart 4. Have no prior neurological or psychiatric disease, including stroke or dementia 5. Can give informed consent and participate in cognitive testing and MRI scans.

Exclusion criteria

1. Known prior stroke or dementia 2. Significant medical co-morbidities making survival for 24 months unlikely 3. Normal exclusion criteria for MRI, e.g. pacemaker, implanted metal, severe claustrophobia 4. Severe diabetic nephropathy, eGFR<30

Outcome results