title: Subgroups of Alzheimer's disease associated with diabetes mellitus based on brain imaging.
abstract: OBJECTIVE
  We attempted to define possible subgroups of Alzheimer's disease (AD) associated with diabetes mellitus (DM) based on brain imaging.
  
  
  METHODS
  We classified 175 patients with clinically diagnosed AD and type 2 DM into 4 subgroups on the basis of the presence or absence of cerebrovascular disease (CVD) on MRI (CVD or no CVD) and posterior cerebral hypoperfusion on SPECT (AD pattern or no AD pattern). Differences in the clinical characteristics among the subgroups were examined.
  
  
  RESULTS
  The subgroup showing neither a CVD pattern nor an AD pattern had significantly older age, higher hemoglobin A1c level, longer duration of diabetes, higher frequency of insulin therapy, lower frequency of apolipoprotein E4 carriers, less severe medial temporal lobe atrophy, more impaired attention, less impaired word recall, and slower progression of cognitive impairment than the subgroup showing an AD pattern. We found no characteristic features of other subgroups.
  
  
  CONCLUSIONS
  The clinical features of subjects with AD associated with DM may differ depending on brain imaging patterns. Among them, there may be a dementia subgroup with characteristics predominantly associated with DM-related metabolic abnormalities.
authors.affiliation: Department of Geriatric Medicine, Tokyo Medical University, Tokyo 160-0023, Japan.
authors.forename: Raita
authors.initials: R
authors.lastname: Fukazawa
authors.forename: Haruo
authors.initials: H
authors.lastname: Hanyu
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Sato
authors.forename: Soichiro
authors.initials: S
authors.lastname: Shimizu
authors.forename: Shunichi
authors.initials: S
authors.lastname: Koyama
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Kanetaka
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Sakurai
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Iwamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000473:pathology* / Q000523:psychology; D001057:Apolipoproteins E / Q000235:genetics; D001284:Atrophy; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D048909:Diabetes Complications / Q000473:pathology* / Q000523:psychology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging; D009483:Neuropsychological Tests; D010641:Phenotype; D013702:Temporal Lobe / Q000473:pathology; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D001057:Apolipoproteins E