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Clinical Manifestations.

Veerle van Gils1, Carlos Gómez-Martínez2,3,4, Miranda T Schram5,6

  • 1Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Limburg, Netherlands.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
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Summary
This summary is machine-generated.

Glycemic dysregulation and inflammation independently impact cognitive decline and brain volume. Lower inflammation levels may increase vulnerability to cognitive decline from poor glucose control, highlighting the need for combined management.

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Area of Science:

  • Neuroscience
  • Endocrinology
  • Gerontology

Background:

  • The synergistic relationship between glycemic dysregulation and peripheral inflammation on cognitive decline and brain structure remains unclear.
  • Investigating these combined effects is crucial for understanding age-related cognitive impairment.

Purpose of the Study:

  • To examine the synergistic and independent associations of glycemic status and inflammation with cognitive decline over 9 years.
  • To assess the impact of glycemic status and inflammation on brain volumes using MRI.

Main Methods:

  • The Maastricht Study analyzed 2,832 participants, assessing glycemic status (normoglycemia, prediabetes, type 2 diabetes mellitus) and a plasma inflammation composite score.
  • Longitudinal cognitive function and cross-sectional MRI brain volumes (grey matter, white matter, hippocampus) were evaluated using linear mixed modeling and linear regression.
  • Analyses were adjusted for covariates, with a focus on interactions between glycemic status, HbA1c, and inflammation.

Main Results:

  • No significant synergistic interaction was found between glycemic status and inflammation on cognitive decline.
  • Type 2 diabetes mellitus and inflammation were independently associated with accelerated cognitive decline.
  • An interaction between HbA1c and inflammation showed higher cognitive decline in individuals with lower inflammation and higher HbA1c.
  • Type 2 diabetes mellitus, HbA1c, and inflammation were independently linked to reduced grey matter volume.
  • Type 2 diabetes mellitus and prediabetes were associated with lower white matter and hippocampal volumes.

Conclusions:

  • Glycemic dysregulation and peripheral inflammation are independently associated with cognitive decline and reduced brain volumes.
  • Individuals with lower inflammation may be more susceptible to cognitive decline when experiencing glycemic dysregulation.
  • Combined management of glucose control and inflammation is important for mitigating cognitive decline.