Affiliations: Department of Neurology, Baylor College of Medicine,
Houston, TX, USA | Neurology Care Line, The Michael E. DeBakey VA Medical
Center, Houston, TX, USA | Menninger Department of Psychiatry and Behavioral
Sciences, Baylor College of Medicine, Houston, TX, USA | Center for Quality of Care and Utilization Studies,
Veterans Affairs Medical Center, Houston, TX, USA | University of Houston, College of Pharmacy, Houston,
TX, USA | VA South Central Mental Illness Research Education and
Clinical Center, Houston, TX, USA
Note: [] Corresponding author: Paul E. Schulz, M.D., Associate Professor
of Neurology, UT Health, 6410 Fannin Suite 1014, Houston, TX 77030, USA. Tel.:
+1 832 325 7080; Fax: +1 713 512 2239; E-mail: Paul.E.Schulz@uth.tmc.edu
Abstract: Background: Vascular dementia (VaD) is the second most common
dementing illness. Multiple risk factors are associated with VaD, but the
individual contribution of each to disease onset and progression is unclear. We
examined the relationship between diabetes mellitus type 2 (DM) and the
clinical variables of VaD. Methods: Data from 593 patients evaluated
between June, 2003 and June, 2008 for cognitive impairment were prospectively
entered into a database. We retrospectively reviewed the charts of 63 patients
who fit the NINDS-AIREN criteria for VaD. The patients were divided into those
with DM (VaD-DM, n=29) and those without DM (VaD, n=34). The groups were
compared with regard to multiple variables. Results: Patients with DM had a significantly earlier onset of VaD (71.9 ± 6.54 vs. 77.2 ± 6.03,
p< 0.001), a faster rate of decline per year on the mini mental state
examination (MMSE; 3.60 ± 1.82 vs. 2.54 ± 1.60 points, p= 0.02), and
a greater prevalence of neuropsychiatric symptoms at the time of diagnosis
(62% vs. 21%, p=0.02). Conclusions: A history of pre-morbid DM
was associated with an earlier onset and faster cognitive deterioration in VaD.
Moreover, DM was associated with neuropsychiatric symptoms in patients with
VaD. A larger study is needed to verify these associations. It will be
important to investigate whether better glycemic control will mitigate the
potential effects of DM on VaD.
