Link between diabetes and early dementia

Understanding the link between diabetes and early dementia -- as well as how diabetes relates to other causes of memory loss -- is the focus of a new study at Columbia University Medical Center and approximately 40 other medical institutions nationwide. The study, ACCORD-MIND, is the first major trial to test whether changing the profile of cardiovascular risk factors reduces memory loss in older persons. Columbia University Medical Center will be the coordinating center for the northeastern United States .

"People with diabetes have a greater risk of memory loss with age and at least twice the risk of developing Alzheimer's disease as people without diabetes," says Ronald M. Lazar, M.D., professor of clinical neuropsychology in neurology and neurological surgery at Columbia University College of Physicians & Surgeons and principal investigator for ACCORD-MIND's northeastern network. "We want to learn how to control diabetes so that we also reduce the risk of memory decline."

It is known that higher risk for cardiovascular problems occurs with poorly controlled blood sugar and elevated blood pressure and lipids. ACCORD-MIND researchers will determine whether more stringent control of these risk factors in diabetics will reduce structural changes in the brain and the rate of memory decline.

This will be the first randomized study of long-term blood sugar control, cognitive function, and structural brain changes in people with Type 2 diabetes. Some participants will undergo brain scans using magnetic resonance imaging to learn more about structural changes that occur in the brains of people with diabetes.

"We want to learn if there is a more favorable level of control that helps minimize diabetes-related memory loss," says Lazar. "We may even learn more about the mechanisms of some conditions like Alzheimer's disease or stroke-related dementia."

ACCORD-MIND is part of a larger ACCORD project focusing on reducing the risk of heart disease and stroke in people with diabetes. ACCORD-MIND will enroll about 2,800 participants at 40 sites in the Southeast, Northeast, Minnesota , Iowa and the West Coast. About 700 people from the New York-New Jersey region will participate. The larger ACCORD study will enroll about 10,000 people nationwide and last for eight years. Volunteers with diabetes who are older than 55 are needed; more information is available by calling 212-305-2920.

The research is funded by the National Institute on Aging in cooperation with the National Heart, Lung and Blood Institute.