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Several risk factors in middle age adversely affect brain size, function later in life

Debette S. Neurology. 2011;77:461-468.

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Diabetes, high blood pressure, smoking and being overweight during middle age may have severe consequences on brain aging and cognition a decade later, according to results of a recent study.

“These factors appeared to cause the brain to lose volume, to develop lesions secondary to presumed vascular injury, and also appeared to affect its ability to plan and make decisions as quickly as 10 years later. A different pattern of association was observed for each of the factors,” Charles DeCarli, MD,from the University of California at Davis in Sacramento, Calif., said in a press release.

DeCarli and fellow researchers examined 1,352 individuals (mean age, 54 years) without dementia from the Framingham Offspring Study to determine the association between midlife vascular risk factors and change in MRI markers of brain injury and cognitive function 10 years later.

They reported that hypertension was linked with accelerated white matter hyperintensity volume (WMHV; P<.001), one of the MRI markers, and a decline in executive function (P=.012), whereas diabetes correlated with a marked increase in temporal horn volume (P=.012), a marker for accelerated hippocampal atrophy. Smoking also correlated with a rise in temporal horn volume (P=.012), while additionally proving detrimental to both total brain volume (P=.025) and extensive change in WMHV (P=.021).

Furthermore, obesity was a predictor of a top quartile change in executive function (P=.035), while increasing waist-to-hip ratio led to a decline in total brain volume (P=.021).

"Our findings provide evidence that identifying these risk factors early in people of middle age could be useful in screening people for at-risk dementia and encouraging people to make changes to their lifestyle before it's too late,” DeCarli said in the release.

Disclosure: Dr. DeCarli serves as a consultant for Takeda Pharmaceutical Company Limited and Avanir Pharmaceuticals, receives research support from Merck Serono and the NIH, and is the editor-in-chief of Alzheimer Disease and Associated Disorders.

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