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Diabetes and Dementia (D2)

Type 2 diabetes mellitus (T2DM) and dementia are two of the most common and most disabling conditions worldwide, responsible for an enormous and growing burden of disease.

Aims

In this study we will establish whether people with T2DM and LVH have increased rates of brain atrophy and cognitive decline compared to people with T2DM but without LVH. 

There is increasing awareness that the two conditions are linked, with cognitive impairment (worsening memory, thinking, perception) common in patients with T2DM, and a strong association between T2DM and Alzheimer’s disease, the most common form of dementia.

But which patient will dement? And which biomarker will predict cognitive decline? We need better biomarkers if we want to better manage the long-term complications of diabetes.  Left ventricular hypertrophy (LVH) is potentially such a marker as it is prevalent in diabetes and a strong, independent predictor of cardiovascular disease events, such as stroke and heart failure. To date there have been no studies investigating the association between LVH and cognitive decline in T2DM.

A single centre observational case control study that will follow 168 adult patients aged >50 years with type 2 diabetes, 50% with LVH (case) and 50% without (control). The study will intensively document the cardiovascular status of patients, perform brain imaging and neuropsychological testing between two time-points, baseline (0 months) and 2 years.

Baseline and 2 year testing includes structural neuroimaging with MRI to assess global brain volume, regional cortical thickness and hippocampal volume, an echocardiogram to assess the absence or presence of LVH, a carotid ultrasound to assess vascular disease, 24-hour ambulatory blood pressure and ECG monitoring, cognitive assessment, and APOE gene risk assessment.

Progress:

The study has received ethics approval (HREC/15/Austin/490) and recruitment commenced in May 2016.

Project Team: 

Collaboration between the Florey Institute, University of Melbourne and Austin Health

Project Collaborators:

Dr Elif Ekinci, Dr Piyush Srivastava, Dr Jay Ramchand, Dr Bryan Wai Associate, Professor Brian Chambers, Associate Professor Christopher O’Callaghan &  Professor Louise Burrell.

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