Diabetes mellitus and white matter hyperintensity

• Published in: Geriatrics & gerontology international Vol. 15; no. S1; pp. 34 - 42
• Main Authors: Tamura, Yoshiaki, Araki, Atsushi
• Format: Journal Article
• Language: English
• Published: Japan Blackwell Publishing Ltd 01.12.2015
• Subjects: Aged; Aged, 80 and over; Aging - physiology; Brain; Brain Diseases - diagnosis; Brain Diseases - epidemiology; Comorbidity; Cross-Sectional Studies; deep white matter hyperintensity; Diabetes; diabetes mellitus; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diffusion Magnetic Resonance Imaging - methods; Disease Progression; Female; Geriatric Assessment - methods; geriatric syndrome; Gerontology; Humans; Hypertension; Hypertension - physiopathology; Incidence; Insulin Resistance - physiology; Leukoaraiosis - pathology; Leukoaraiosis - physiopathology; Male; Neurology; paraventricular leukoaraiosis; Prospective Studies; Risk Assessment; Risk factors; White Matter - pathology; White Matter - physiopathology; white matter hyperintensity; geriatric syndrome; diabetes mellitus; paraventricular leukoaraiosis; deep white matter hyperintensity; white matter hyperintensity
• ISSN: 1444-1586; 1447-0594
• DOI: 10.1111/ggi.12666

White matter hyperintensity (WMH) is a brain lesion detected as a high‐intensity area in magnetic resonance imaging T2 and fluid‐attenuated inversion recovery images, and it has been suggested that WMH reflects damage to small vessels in periventricular and subcortical areas. Although WMH has been linked to the incidence of stroke, more recently it has been clarified that WMH is also associated with progression of cognitive decline and functional disability, which are components of so‐called geriatric syndrome. In addition to hypertension, which is the classical risk factor for WMH, evidence has been accumulating to suggest that diabetes mellitus could also be associated with WMH progression, and some studies have shown that WMH severity is correlated with cognitive decline in patients with diabetes. The factors that accelerate WMH formation in elderly patients with diabetes remain poorly defined. It is considered that insulin resistance is an exacerbating factor, but the effects of hypertension, dyslipidemia or other vascular risk factors have yet be clarified, and further studies are required. Geriatr Gerontol Int 2015; 15 (Suppl. 1): 34–42.