Association of long‐term hyperglycaemia and insulin resistance with brain atrophy and cognitive decline: A longitudinal cohort study
Authors' conclusion
Long-term hyperglycaemia was a major independent factor associated with rapid cognitive decline in middle-aged adults with diabetes. Maintaining ideal glucose levels in diabetes at midlife might prevent later rapid cognitive decline.
Study context
- Population
- Middle-aged adults, Ansan cohort of the Korean Genome Epidemiology Study, with baseline and 4-year follow-up brain MRI and neuropsychological measures
- Participants
- 2,377 adults
- Exposure
- T2D vs normal glucose
- Outcome
- Brain volume and cognitive change
- Follow-up
- 4.2 years
Main finding
As reported in the abstract
4.2 years
Diabetes vs Normal glucoseAdjusted volume difference, ml (95% CI)
White matter volume; greater reduction with T2D
−1.96(−3.73 to −0.18)
- Executive function; greater decline with T2D
- adjusted Z score difference −0.14 (95% CI −0.23 to −0.05)
Observational data: associations, not effects.
Further findings
Executive function decline vs time-weighted mean HbA1c over preceding 10.6 years, diabetes group
- Greater executive function decline associated with higher time-weighted mean HbA1c
- P < 0.001
- Not associated with insulin resistance markers
Diabetes with time-weighted average HbA1c >6.5% over previous decade
- Greater decline in executive function and global cognition than normal glucose group
Original publication
Association of long‐term hyperglycaemia and insulin resistance with brain atrophy and cognitive decline: A longitudinal cohort study. Diabetes Obes Metab. Published 10 January 2023. doi:10.
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