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Clinical Trials Update
May 28, 2014

Midlife Diabetes, Hypertension, May Affect Cognition Later in Life

JAMA. 2014;311(20):2056. doi:10.1001/jama.2014.5901

The onset of diabetes and hypertension in midlife affects brain pathology and may lead to cognitive impairment later in life, according to a study of 1437 individuals (Roberts R et al. Neurology. doi:10.1212/WNL.0000000000000269 [published online March 19, 2014]).

Participants (mean age 80 years) underwent brain scans with magnetic resonance; their medical records established diabetes and hypertension in midlife or later. Diabetes in midlife was associated with subcortical infarctions and whole-brain and hippocampal atrophy, which may be the pathway for cognitive decline later in life, the researchers said. Midlife hypertension was associated with infarctions and white matter hyperintensity volume changes and was marginally associated with reduced performance in executive function. Individuals who developed hypertension and diabetes later in life showed fewer adverse effects on brain pathology and cognition.

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