Author Interviews, Biomarkers, Brain Cancer - Brain Tumors, Chemotherapy, Neurology, Radiation Therapy / 20.08.2015

Jorg Dietrich, MBA MMSc MD PhD Director, Cancer & Neurotoxicity Clinic and Brain Repair Research Program Massachusetts General Hospital Cancer Center Assistant Professor of Neurology Harvard Medical SchoolMedicalResearch.com Interview with: Jorg Dietrich, MBA MMSc MD PhD  Director, Cancer & Neurotoxicity Clinic and Brain Repair Research Program Massachusetts General Hospital Cancer Center Assistant Professor of Neurology Harvard Medical School Medical Research: What is the background for this study? What are the main findings? Dr. Dietrich: Understanding the adverse effects associated with cancer therapy is an important issue in oncology. Specifically, management of acute and delayed neurotoxicity of chemotherapy and radiation in brain cancer patients has been challenging. There is an unmet clinical need to better characterize the effects of standard cancer therapy on the normal brain and to identify patients at risk of developing neurotoxicity. In this regard, identifying novel biomarkers of neurotoxicity is essential to develop strategies to protect the brain and promote repair of treatment-induced damage. In this study, we demonstrate that standard chemotherapy and radiation in patients treated for glioblastoma is associated with progressive brain volume loss and damage to gray matter – the area of the brain that contains most neurons. A cohort of 14 patients underwent sequential magnetic resonance imaging studies prior to, during and following standard chemoradiation to characterize the pattern of structural changes that occur as a consequence of treatment. (more…)
Author Interviews, Beth Israel Deaconess, Cognitive Issues, Diabetes, Neurology / 11.07.2015

Vera Novak, MD PhD Associate Professor of Neurology Dept. of Neurology, Stroke Division Director Syncope and Falls in the Elderly Laboratory Beth Israel Deaconess Medical Center Boston, MAMedicalResearch.com Interview with: Vera Novak, MD PhD Associate Professor of Neurology Dept. of Neurology, Stroke Division Director Syncope and Falls in the Elderly Laboratory Beth Israel Deaconess Medical Center Boston, MA MedicalResearch: What is the background for this study? Dr. Novak: Diabetes mellitus (DM) is a major contributor to morbidity and mortality. Type 2 diabetes mellitus affects more than 44 million people in the U.S., and its numbers are growing rapidly, affecting up to 27% of older adults. Diabetes mellitus accelerates brain aging by about 5 years1, manifests as a widespread generalized atrophy2, and promotes earlier onset of vascular dementia and Alzheimer’s disease (AD).3,4 Diabetes mellitus -related atrophy manifests as worse cognitive function, memory, and gait, especially during a dual task, 5,6 and even a tight glycemic control did not improve cognitive function in participants of the large clinical trials 7. MedicalResearch: What are the main findings? Dr. Novak: Sixty-five participants (aged 66± 9.2 years) 35 with T2DM and 30 non-diabetic controls participated in this study. After 2 years of follow-up, participants with T2 Diabetes mellitus had diminished vascular reactivity in the brain (an ability to increase blood flow in responses to a task or metabolic demands) and performed worse on multiple cognitive tasks (in particular verbal learning and memory). In T2DM group, lower cerebral vasoreactivity correlated with worse performance on daily living activities. Specifically, the lower vasodilatation (ability to increase blood flow) was associated with worse mental functions. In addition, those with higher markers of inflammation had greater decline in vascular function in the brain. (more…)
Author Interviews, MRI, Neurology, Stroke / 14.05.2015

Amie W. Hsia, MD Medical Director, Comprehensive Stroke Center MedStar Washington Hospital Center NIH Stroke Program at MWHC Associate Professor, Neurology Georgetown University Washington, DC 20010MedicalResearch.com Interview with: Amie W. Hsia, MD Medical Director, Comprehensive Stroke Center MedStar Washington Hospital Center NIH Stroke Program at MWHC Associate Professor, Neurology Georgetown University Washington, DC 20010   Medical Research: What is the background for this study? What are the main findings? Dr. Hsia: Acute stroke is a common presenting problem in the emergency department. We know that “time is brain” and that for patients experiencing an ischemic or “blockage” type of stroke, the most common type, the sooner we can administer tPA, a clot-busting medication and the only FDA-approved medication to treat acute stroke, the better chance for a good outcome. Therefore, there is a goal national benchmark time of administering the drug to appropriate acute stroke patients within 60 minutes of their arrival to the emergency department. There are many steps that are necessary in the evaluation of an acute stroke patient in the emergency department before tPA can be given. This includes a brain scan to make sure a patient is not having the less common bleeding type of stroke. A CT or “CAT” scan is the typical type of brain scan that is performed in emergency departments across the country and the world to screen a patient before giving tPA. The primary purpose of the CT scan is to exclude bleeding; it is difficult to visualize an early stroke on CT. Though an MRI can give more complete information including showing the stroke as it is happening in these first few hours and though most hospitals have an MRI scanner, an MRI takes longer to perform and has not traditionally been used in an emergency setting. At the two hospitals included in this study, MedStar Washington Hospital Center in D.C. and Suburban Hospital in Maryland, we are fortunate to serve as the sites for the NINDS intramural stroke clinical research program and use MRI routinely to screen acute stroke patients to learn more about stroke and develop new treatments for stroke. It is upon this foundation that we performed independent hospital-wide quality improvement initiatives engaging multidisciplinary committees with leadership from all the departments involved in the care of the acute stroke patient in that critical first 60 minutes. Inspired by our colleagues at Washington University in St. Louis led by Dr. Andria Ford who used similar methods in reducing treatment times with CT screening, we used lean manufacturing principles to streamline our processes that include MRI screening and dramatically reduced our treatment times from a baseline of 93 minutes down to 55 minutes while still maintaining safety. Through these efficiency improvements, we were able to achieve a 4-fold increase in the percentage of stroke patients treated with tPA within 60 minutes. (more…)
Author Interviews, Brain Injury, Neurology, Parkinson's / 20.02.2015

MedicalResearch.com Interview with: Line Kenborg, MSc, PhD Survivorship Unit Danish Cancer Society Research Center Copenhagen Medical Research: What is the background for this study? What are the main findings? Response: The hypothesis that head injuries increase the risk for Parkinson disease has been examined in many studies during the past decades, but the findings have been highly inconsistent. We have previously examined the hypothesis in a study based on information on head injuries and Parkinson disease from the Danish National Hospital Registry. In this study, we found a positive association between a hospital contact for a head injury in middle or late adulthood and a diagnosis of Parkinson disease. The reported association, however, was almost entirely due to injuries that occurred during the months preceding the first hospital contact for Parkinson disease. Because we used information from registries, we lacked detailed diagnostic information to distinguish Parkinson disease from other types of parkinsonism, and we had no information on milder head injuries and head injuries in early life. So we wanted to study whether head injuries throughout life increased the risk for Parkinson disease in the largest interview-based case-control study to date including patients with a verified diagnosis of Parkinson disease. The main finding of our study is that we do not find any association between head injuries and Parkinson disease. (more…)
Author Interviews, Neurological Disorders, Neurology, Pediatrics, Sleep Disorders / 23.01.2015

James Tao, MD, Ph.D Assistant Professor Director, EEG Lab Department of Neurology, The University of Chicago, IL.MedicalResearch.com Interview with: James Tao, MD, Ph.D Assistant Professor Director, EEG Lab Department of Neurology, The University of Chicago, IL. Medical Research: What is the background for this study? What are the main findings? Dr. Tao: Sudden unexpected death in epilepsy (SUDEP) is the leading cause of mortality in patients with chronic uncontrolled epilepsy. Patients often died in sleep, in bed, and unwitnessed. They were often found in prone position. These circumstances of SUDEP are remarkably similar to those of sudden infant death syndrome (SIDS). In our study, we found that 73% of 253 SUDEP patients were died in prone position. These findings suggest that sudden unexpected death in epilepsy may share the mechanisms similar to SIDS. (more…)
Alzheimer's - Dementia, Author Interviews, Neurology / 07.10.2014

Lena Johansson, PhD, MSc, RN Institute of Neuroscience and Physiology Department of Psychiatry and Neurochemistry Sahlgrenska Academy at Gothenburg UniversityMedicalResearch.com Interview with: Lena Johansson, PhD, MSc, RN Institute of Neuroscience and Physiology Department of Psychiatry and Neurochemistry Sahlgrenska Academy at Gothenburg University Medical Research: What are the main findings of the study? Dr. Johansson: We found that a higher degree of neuroticism in midlife was associated with increased risk of Alzheimer’s disease over 38 years. On the 24 point scale, the risk increased with 4% per each step. Women who score high on the neuroticism scale were more likely to experience feelings such as anxiety, nervousness, worry, and irritability, and they were more moodiness and stress-prone. The association between neuroticism and Alzheimer’s disease diminished after adjusting for longstanding perceived distress symptoms, which suggest that the associations was at least partly depended on long-standing distress symptoms. When the two personality dimensions were combined, women with high neuroticism/low extraversion had a double risk of Alzheimer’s disease compared to those with low neuroticism/high extraversion. (more…)
Author Interviews, Cognitive Issues, General Medicine, Mental Health Research, Neurology / 26.09.2014

Richard J. Kryscio, PhD, Professor Sanders-Brown Center on Aging University of KentuckyMedicalResearch.com Interview with: Richard J. Kryscio, PhD, Professor Sanders-Brown Center on Aging University of Kentucky Medical Research: What are the main findings of the study? Dr. Kryscio:  We followed 531 elderly over time assessing their cognition annually; of these 105 (about 20%) eventually were diagnosed with a serious cognitive impairment (either a mild cognitive impairment or a dementia) and 77% of the latter declared a subjective memory complaint prior to the diagnosis of the impairment.  In brief, declaration of a memory problem put a subject at three times the risk of a future impairment. (more…)
Author Interviews, Multiple Sclerosis, Neurology, Salt-Sodium / 28.08.2014

MedicalResearch.com Interview with: Dr. Mauricio Farez Department of Neurology, Raúl Carrea Institute for Neurological Research Buenos Aires, Argentina Medical Research: What are the main findings of the study? Dr. Farez: Our study shows that patients with Multiple Sclerosis (MS) with moderate to high sodium (salt) intake have also increased disease activity (more clinical relapses and more lesions on MRIs). (more…)
Author Interviews, Neurological Disorders, Neurology / 23.08.2014

Mahyar Etminan PharmD, MSc Scientist I Pharmaceutical Outcomes Programme (POPi) Faculty of Medicine | Assistant Professor, Department of Pediatrics The University of British Columbia | Child and Family Research Institute (CFRI) Vancouver, BC V5Z 4H4MedicalResearch.com Interview with: Mahyar Etminan PharmD, MSc Scientist I Pharmaceutical Outcomes Programme (POPi) Faculty of Medicine | Assistant Professor, Department of Pediatrics The University of British Columbia | Child and Family Research Institute (CFRI) Vancouver, BC Medical Research: What are the main findings of the study? Dr. Eiminan: Current users of Fluoroquinolones are at a twice their risk of developing peripheral neuropathy than non users. (more…)
Author Interviews, Diabetes, Kidney Disease, Neurology, Stroke / 21.08.2014

MedicalResearch.com Interview with: Prof. Chia-Huang Kao From the Graduate Institute of Clinical Medical Science Department of Radiation Oncology and Nuclear Medicine and PET Center Graduate Institute of Clinical Medical Science China Medical University Hospital, Taichung, Taiwan. Medical Research: What are the main findings of the study? Prof. Kao: Patients with chronic kidney disease (CKD) are at high risk for hypoglycemia; several factors are reported to contribute to hypoglycemia in these patients. However, most previous studies were limited by the relatively small number of patients with CKD included in the study by the exclusion of cases with CKD. In the present study, the incidence rate of hypoglycemia in patients with CKD was 4.5%, which is approximately twice the value noted in previous reports and multivariate analysis revealed a 2.53-fold increase in the risk of death for CKD patients with hypoglycemia after adjusting for related confounding factors including hypertension, hyperlipidemia, diabetes, and antidiabetic drugs. (more…)
Author Interviews, Neurology, Parkinson's / 30.07.2014

Associate Professor of Psychiatry and Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA 19104-2676 Parkinson's Disease Research, Education and Clinical Center (PADRECC) Mental Illness Research, Education and Clinical Center (MIRECC) Philadelphia Veterans Affairs Medical CenterMedicalResearch.com Interview with: Daniel Weintraub, M.D. Associate Professor of Psychiatry and Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA 19104-2676 Parkinson's Disease Research, Education and Clinical Center (PADRECC) Mental Illness Research, Education and Clinical Center (MIRECC) Philadelphia Veterans Affairs Medical Center Medical Research: What are the main findings of the study? Dr. Weintraub: That there is mixed evidence for the efficacy of naltrexone in the treatment of impulse control disorders in Parkinson’s disease, and the evidence is sufficient to support further study of this compound class for this indication.  In addition, the study demonstrates that it is possible to conduct a clinical trial in this area. (more…)
Author Interviews, Cognitive Issues, Neurology / 25.07.2014

Joe Verghese, MBBS, MS Professor of Neurology and Medicine, Chief, Integrated Divisions of Cognitive & Motor Aging (Neurology) and Geriatrics (Medicine), Director, Resnick Gerontology Center, Murray D Gross Memorial Faculty Scholar in Gerontology, Albert Einstein College of Medicine Bronx, NY 10461MedicalResearch.com Interview with: Joe Verghese, MBBS, MS Professor of Neurology and Medicine, Chief, Integrated Divisions of Cognitive & Motor Aging (Neurology) and Geriatrics (Medicine),  Director, Resnick Gerontology Center, Murray D Gross Memorial Faculty Scholar in Gerontology, Albert Einstein College of Medicine, Bronx, NY 10461 Medical Research: What are the main findings of the study? Answer: Motoric Cognitive Risk Syndrome (MCR) is a newly described pre-dementia syndrome that is characterized by presence of slow gait and cognitive complaints in older adults without dementia or mobility disability. In this study, we report that the prevalence of Motoric Cognitive Risk Syndrome was 9.7% in 26,802 adults aged 60 and older from 22 cohort studies based in 17 countries. Presence of Motoric Cognitive Risk Syndrome was also associated with an almost two-fold risk of developing dementia. (more…)
Author Interviews, Neurology, Stroke / 20.07.2014

Sang-Beom Jeon, MD, PhD From the Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul, Republic of Korea.MedicalResearch.com Interview with: Sang-Beom Jeon, MD, PhD From the Department of Neurology Asan Medical Center University of Ulsan College of Medicine Seoul, Republic of Korea. Medical Research: What are the main findings of the study? Dr. Sang-Beom Jeon: In this MRI study of 825 stroke patients, we demonstrated that high plasma concentrations of homocysteine, also known as hyperhomocysteinemia, were associated with small-vessel disease (lacunar infarcts and leukoaraiosis) and large-vessel atherosclerosis of cerebral arteries. (more…)
Author Interviews, Dartmouth, Hospital Readmissions, Neurological Disorders, Neurology / 25.06.2014

MedicalResearch.com Interview with: Tracie A. Caller, MD , MPH Neurophysiology Fellow Dartmouth-Hitchcock Medical Center 1 Medical Center Dr., Lebanon NH 03756, USA MedicalResearch: What are the main findings of the study? Dr. Caller: We identified factors that appeared to increase the risk for a 30 day readmissions in the epilepsy population, which included refractory seizures but also coexistence of nonepileptic seizures and psychiatric comorbidities. (more…)
Author Interviews, Neurology / 14.05.2014

MedicalResearch.com Interview with: András Szentkirályi, MD, PhD Research fellow:Westfälische Wilhelms-Universität Münster Institut für Epidemiologie und Sozialmedizin Germany, D-4814 MedicalResearch: What are the main findings of the study? Dr. Szentkirályi : Based on two prospective, population-based cohort studies, we found that subjects having multiple chronic diseases are at an increased risk of suffering from restless legs syndrome (RLS). Moreover, increased multimorbidity was a significant predictor of developing new onset RLS. It is important to note that the observed relationship was not reduced when well-established causes of secondary restless legs syndrome (e.g. chronic renal disease) were excluded. (more…)
Cannabis, Neurology, Stroke / 09.05.2014

MedicalResearch.com Interview with: Tara Dutta M.D. Vascular Neurology Fellow University of Maryland Medical Center MedicalResearch: What are the main findings of the study? Dr. Dutta: We analyzed data from the Stroke Prevention in Young Adults Study in order to evaluate for an association between self-reported marijuana use and ischemic stroke.   1,101 cases and 1,154 age, gender, and race-matched controls, aged 15-49 years old, were recruited from the greater Baltimore-Washington area between 1992 and 2008. Interviews were conducted to assess for various potential stroke risk factors, including illicit drug, alcohol, and tobacco use. Individuals reporting use of vasoactive illicit drugs, including cocaine and amphetamines, were excluded, yielding 751 cases and 813 controls. Logistic regression analysis was used to determine the association between marijuana use and ischemic stroke, adjusting for age, gender, race, current tobacco use, current alcohol use, hypertension, and diabetes. We did not find a positive association between marijuana use and ischemic stroke risk in our population of young-onset stroke patients compared to matched controls, even after controlling for current tobacco and alcohol use, hypertension, and diabetes.   A statistically significant inverse relationship was observed between remote use (defined as any use over one year ago) and stroke risk (adjusted OR 0.77, CI 0.61-0.98, p = 0.03). We also looked to see whether recent use (in the past 30 days), and particularly recent heavy use, was associated with ischemic stroke risk as has been suggested in the medical literature. Though our data did not show this association, the number of patients reporting recent use in our study was very small­­­­­­­. (more…)
Author Interviews, Mayo Clinic, Neurology, Stroke / 06.05.2014

Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Mayo Clinic, Rochester, MN 55905 MedicalResearch.com Interview with: Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Mayo Clinic, Rochester, MN 55905 MedicalResearch: What are the main findings of the study? Dr. Kantarci: Microinfarcts are one of the most common pathologies identified in the brains of older individuals and they impact cognition. However they are invisible lesions on MRI. We demonstrated that presence of microinfarcts in autopsied individuals are associated with the macroinfarcts identified on their MRI scans than they were alive. We also demonstrated that the presence of these invisible lesions are related to greater brain atrophy rates that are localized to watershed zones. (more…)
Author Interviews, Erasmus, Neurology, Stroke / 25.04.2014

M. Arfan Ikram, MD, PhD Assistant professor in Neuroepidemiology Erasmus Medical Center Rotterdam, the NetherlandsMedicalResearch.com Interview with: M. Arfan Ikram, MD, PhD Assistant professor in Neuroepidemiology Erasmus Medical Center Rotterdam, the Netherlands MedicalResearch.com: What are the main findings of this study? Dr. Ikram: We show that the risk of stroke might be increased due to an increased risk of ischemic stroke or increased risk of hemorrhagic stroke. Because these subtypes of stroke require different -often opposite- clinical management, currently available prediction rules for any stroke are insufficient. We propose a novel prediction rule that provides separate risks for ischemic stroke and hemorrhagic stroke. (more…)
Author Interviews, Neurology / 08.04.2014

Xiang Gao, MD, PhD Assistant Professor in Medicine Harvard Medical School Associate Epidemiologist Brigham and Women's HospitalMedicalResearch.com Interview with: Xiang Gao, MD, PhD Assistant Professor in Medicine Harvard Medical School Associate Epidemiologist Brigham and Women's Hospital MedicalResearch.com: What are the main findings of the study? Dr. Gao: In this study including 12,556 men in the Health Professionals Follow-up Study, we found that the participants with Restless Legs Syndrome at baseline had significantly lower physical function (PF) score 6 years later than those without RLS, after adjusting for potential confounders. The magnitude of difference in physical function score for RLS symptoms ≥15 times/month vs no Restless Legs Syndrome was more than that of a 5-year increase of age or moderate amount of smoking. We also found that having daily daytime sleepiness and sleep duration ≥9 hours/day were associated with lower mean physical function value than not having these symptoms . (more…)
Author Interviews, Cognitive Issues, Exercise - Fitness, Neurology / 07.04.2014

David R. Jacobs Jr, PhD Divisions of Epidemiology School of Public Health University of Minnesota, MinneapolisMedicalResearch.com Interview with: David R. Jacobs Jr, PhD Divisions of Epidemiology School of Public Health University of Minnesota, Minneapolis MedicalResearch.com: What are the main findings of this study? Dr. Jacobs: Vigorous activity is what is well understood to improve cardiorespiratory fitness. People with high fitness are likely (based on this study) to a) Lose fitness more slowly as they age and b) To maintain sharper "thinking skills" into late middle age. I think the message of this study is primarily for the people in the low to mid range of fitness in young adulthood.  Thus, of more importance to the general population, if the people with low to moderate fitness simply do things, be engaged in family, job, community, move around, they would  be able to do better on a treadmill test such as we used.  Because those who lost less fitness over average age 25 to average age 45 had higher thinking skills at age 50, people who start moving around are likely to reap the benefit of less loss of thinking skills by average age 50. (more…)
Author Interviews, Multiple Sclerosis, Neurology / 03.04.2014

Jeppe Romme Christensen MD PhD From the Danish Multiple Sclerosis Center Copenhagen University Hospital Hvidovre, Denmark.MedicalResearch.com Interview with: Jeppe Romme Christensen  MD PhD From the Danish Multiple Sclerosis Center Copenhagen University Hospital Hvidovre, Denmark. MedicalResearch.com: What are the main findings of the study? Dr. Christensen: This study demonstrates that progressive multiple sclerosis (MS) patients have reduced inflammation and tissue damage in the brain after treatment with natalizumab. These findings highlight that progressive MS is an inflammatory disease and furthermore that peripheral circulating immune cells contribute to brain inflammation and tissue damage in progressive MS. (more…)
Alcohol, Cognitive Issues, Neurology / 25.03.2014

Osvaldo P. Almeida, MD, PhD, FRANZCP, FFPOA Professor & Winthrop Chair of Geriatric Psychiatry | School of Psychiatry & Clinical Neurosciences | University of Western Australia. Director of Research | Western Australian Centre for Health & Ageing | Centre for Medical Research | Western Australian Institute for Medical Research. Consultant | Department of Psychiatry | Royal Perth Hospital. Australia.MedicalResearch.com Interview with: Osvaldo P. Almeida, MD, PhD, FRANZCP, FFPOA Professor & Winthrop Chair of Geriatric Psychiatry | School of Psychiatry & Clinical Neurosciences | University of Western Australia. Consultant | Department of Psychiatry | Royal Perth Hospital. MedicalResearch.com: What are the main findings of this study? Prof. Almeida: This study used the principles of Mendelian randomisation to clarify whether alcohol use is a direct cause of cognitive impairment in later life. The rationale behind this approach is that the genetic variation associated with lower risk of alcohol abuse or dependence should also be associated with lower risk of cognitive impairment if alcohol misuse is a direct cause cognitive impairment. We found no evidence for such an association. (more…)
Author Interviews, Mental Health Research, Neurology, NIH / 22.03.2014

Hannes Devos, PhD Assistant Professor Assistant Director Georgia Regents University Driving Simulator Lab Department of Physical Therapy College of Allied Health Sciences Georgia Regents University Augusta, GA 30912MedicalResearch.com Interview with: Hannes Devos, PhD Assistant Professor Assistant Director Georgia Regents University Driving Simulator Lab Department of Physical Therapy College of Allied Health Sciences Georgia Regents University Augusta, GA 30912 MedicalResearch.com: What are the main findings of the study? Dr. Devos: We compared on-road driving performance between 30 active drivers with Huntington disease and 30 age- and gender- matched control drivers. We found that Huntington disease affects all levels of driving skill due to motor and cognitive deficits and leads to unsafe driving, even in the early stages of the disease. Fourteen (47%) drivers with Huntington disease failed the road test compared with none of the controls. (more…)
Author Interviews, Diabetes, Mayo Clinic, Neurology / 20.03.2014

Rosebud O Roberts, M.B., Ch.B. Professor of Epidemiology Professor of Neurology Mayo ClinicMedicalResearch.com Interview with: Rosebud O Roberts, M.B., Ch.B. Professor of Epidemiology Professor of Neurology Mayo Clinic   MedicalResearch.com: What are the main findings of the study? Dr. Roberts: The onset of type two diabetes in midlife (before age 65 years)  is associated with brain pathology (subcortical brain infarctions, reduced hippocampal volume, reduced whole brain volume) in late-life. Early onset of diabetes also increases the risk of developing mild cognitive impairment  which is an intermediate stage between normal cognitive aging and dementia. Our findings suggest that loss of brain volumes may be an intermediate stage or a link between diabetes and cognitive impairment. We also found that diabetes onset in late-life (after age 65 years), is also associated with brain pathology (cortical infarctions, reduced whole brain volume). Finally, onset of hypertension in midlife, but not late-life, is associated with brain pathology in late- life. (more…)