ArticleJCI insight2025
Characterization of cognitive decline in long-duration type 1 diabetes by cognitive, neuroimaging, and pathological examinations.
Article in JCI insight, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Age of Type 1 Diabetes Onset and Dementia Risk: A Swedish Nationwide, Register-Based Cohort Study.Diabetes, obesity & metabolism · 2026Article
- Lipidomic signatures associated with cognitive impairment in type 1 diabetes mellitus: a pilot study integrating clinical serum and mouse hippocampus.Journal of translational medicine · 2026Article
- Inflammatory profile associated with hyperglycemia in children with type 1 diabetes.Journal of diabetes and its complications · 2026Article
- Development and validation of a logistic regression model for predicting visual impairment in middle-aged and older adults with diabetes: results from the China Health and Retirement Longitudinal Study.International journal of ophthalmology · 2026Article
- Neuropathic pain in diabetic patients: a review of pharmacological treatment selection according to psychopathological and somatic factors.Frontiers in psychiatry · 2026Review
- Associations between retinal microvasculature and cognition in middle-aged adults with type 1 diabetes without overt neurological symptoms.Cerebral circulation - cognition and behavior · 2026Article
- Longitudinal changes in cognitive function and its related factors in older type 1 diabetes mellitus patients without dementia.Journal of diabetes investigation · 2025Article
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Authors and funding
22 authors.
Funding
Abstract
BACKGROUNDWe aimed to characterize factors associated with the under-studied complication of cognitive decline in aging people with long-duration type 1 diabetes (T1D).METHODSJoslin "Medalists" (n = 222; T1D ≥ 50 years) underwent cognitive testing. Medalists (n = 52) and age-matched nondiabetic controls (n = 20) underwent neuro- and retinal imaging. Brain pathology (n = 26) was examined. Relationships among clinical, cognitive, and neuroimaging parameters were evaluated.RESULTSCompared with controls, Medalists had worse psychomotor function and recall, which associated with female sex, lower visual acuity, reduced physical activity, longer diabetes duration, and higher inflammatory cytokines. On neuroimaging, compared with controls, Medalists had significantly lower total and regional brain volumes, equivalent to 9 years of accelerated aging, but small vessel disease markers did not differ. Reduced brain volumes associated with female sex, reduced psychomotor function, worse visual acuity, longer diabetes duration, and higher inflammation, but not with glycemic control. Worse cognitive function, lower brain volumes, and diabetic retinopathy correlated with thinning of the outer retinal nuclear layer. Worse baseline visual acuity associated with declining psychomotor function in longitudinal analysis. Brain volume mediated the association between visual acuity and psychomotor function by 57%. Brain pathologies showed decreased volumes, but predominantly mild vascular or Alzheimer's-related pathology.CONCLUSION To our knowledge, this is the first comprehensive study of cognitive function, neuroimaging, and pathology in aging T1D individuals demonstrated that cognitive decline was related to parenchymal rather than neurovascular abnormalities, unlike type 2 diabetes, suggestive of accelerated aging in T1D. Improving visual acuity could perhaps be an important preventive measure against cognitive decline in people with T1D.FUNDINGThe Beatson Foundation, NIH/NIDDK grants 3P30DK036836-34S1 and P30DK036836-37, and Mary Iacocca fellowships.
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