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Type 2 Diabetes Mellitus and Impaired Renal Function Are Associated With Brain Alterations and Poststroke Cognitive Decline
- Source :
- Stroke. 48(9)
- Publication Year :
- 2017
-
Abstract
- Background and Purpose— Type 2 diabetes mellitus (T2DM) is associated with diseases of the brain, kidney, and vasculature. However, the relationship between T2DM, chronic kidney disease, brain alterations, and cognitive function after stroke is unknown. We aimed to evaluate the inter-relationship between T2DM, impaired renal function, brain pathology on imaging, and cognitive decline in a longitudinal poststroke cohort. Methods— The TABASCO (Tel Aviv brain acute stroke cohort) is a prospective cohort of stroke/transient ischemic attack survivors. The volume and white matter integrity, ischemic lesions, and brain and hippocampal volumes were measured at baseline using 3-T MRI. Cognitive tests were performed on 507 patients, who were diagnosed as having mild cognitive impairment, dementia, or being cognitively intact after 24 months. Results— At baseline, T2DM and impaired renal function (estimated creatinine clearance [eCCl] Conclusions— T2DM and impaired renal function are independently associated with abnormal brain structure, as well as poorer performance in cognitive tests, 2 years after stroke. The presence of both conditions quadruples the risk for cognitive decline. T2DM and lower eCCl have an independent and additive effect on brain atrophy and the risk of cognitive decline. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01926691.
- Subjects :
- Male
medicine.medical_specialty
Renal function
030209 endocrinology & metabolism
Comorbidity
Neuropsychological Tests
Hippocampus
Cohort Studies
03 medical and health sciences
Executive Function
0302 clinical medicine
Risk Factors
Internal medicine
Diabetes mellitus
medicine
Dementia
Humans
Cognitive Dysfunction
Prospective Studies
Cognitive decline
Israel
Renal Insufficiency, Chronic
Prospective cohort study
Stroke
Aged
Advanced and Specialized Nursing
Cerebral Cortex
business.industry
Brain
Organ Size
Middle Aged
medicine.disease
Magnetic Resonance Imaging
White Matter
Diabetes Mellitus, Type 2
Motor Skills
Cohort
Physical therapy
Cardiology
Female
Neurology (clinical)
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Kidney disease
Subjects
Details
- ISSN :
- 15244628 and 01926691
- Volume :
- 48
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Stroke
- Accession number :
- edsair.doi.dedup.....4eee1c7b7eb05a6e67ce433523dc6e16