Type 2 diabetes increases the risk of developing cognitive dysfunction in the elderly
in the form of short-term memory and executive function impairment. Genetic and diet-induced
models of type 2 diabetes further support this link, displaying deficits in working memory, learning,
and memory performance. The risk factors for diabetic cognitive dysfunction include vascular
disease, hypoglycaemia, hyperlipidaemia, adiposity, insulin resistance, lifestyle factors, and
genetic factors. Using neuronal imaging technologies, diabetic patients with cognitive dysfunction
show atrophy of the whole brain, particularly the grey matter, hippocampus and amygdala;
increased volume of the ventricular and white matter; brain infarcts; impaired network integrity;
abnormal microstructure; and reduced cerebral blood flow and amplitude of low-frequency fluctuations.
The pathogenesis of type 2 diabetes with cognitive dysfunction involves hyperglycaemia,
macrovascular and microvascular diseases, insulin resistance, inflammation, apoptosis,
and disorders of neurotransmitters. Large clinical trials may offer further proof of biomarkers
and risk factors for diabetic cognitive dysfunction. Advanced neuronal imaging technologies and
novel disease animal models will assist in elucidating the precise pathogenesis and to provide
better therapeutic interventions and treatment.