Diabetes is associated with cerebrovascular but not Alzheimer's disease neuropathology

Erin L. Abner, Peter T. Nelson, Richard J. Kryscio, Frederick A. Schmitt, David W. Fardo, Randall L. Woltjer, Nigel J. Cairns, Lei Yu, Hiroko H. Dodge, Chengjie Xiong, Kamal Masaki, Suzanne L. Tyas, David A. Bennett, Julie A. Schneider, Zoe Arvanitakis

Research output: Contribution to journalArticlepeer-review

178 Scopus citations

Abstract

Introduction The relationship of diabetes to specific neuropathologic causes of dementia is incompletely understood. Methods We used logistic regression to evaluate the association between diabetes and infarcts, Braak neurofibrillary tangle stage, and neuritic plaque score in 2365 autopsied persons. In a subset of >1300 persons with available cognitive data, we examined the association between diabetes and cognition using Poisson regression. Results Diabetes increased odds of brain infarcts (odds ratio [OR] = 1.57, P < .0001), specifically lacunes (OR = 1.71, P < .0001), but not Alzheimer's disease neuropathology. Diabetes plus infarcts was associated with lower cognitive scores at end of life than infarcts or diabetes alone, and diabetes plus high level of Alzheimer's neuropathologic changes was associated with lower mini-mental state examination scores than the pathology alone. Discussion This study supports the conclusions that diabetes increases the risk of cerebrovascular but not Alzheimer's disease pathology, and at least some of diabetes' relationship to cognitive impairment may be modified by neuropathology.

Original languageEnglish
Pages (from-to)882-889
Number of pages8
JournalAlzheimer's and Dementia
Volume12
Issue number8
DOIs
StatePublished - Aug 1 2016

Keywords

  • Alzheimer
  • Autopsy
  • Cerebrovascular
  • Cognition
  • Diabetes
  • Infarcts
  • Neuropathology

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