Comparison of Autonomic and Cardiovascular Dysfunction to Cognitive Decline in Persons with Type 2 Diabetes

This thesis investigated the relationship between autonomic and cardiovascular dysfunction and cognitive decline in type 2 diabetes. Autonomic indices such as heart rate, blood pressure, pulse wave velocity and cardiac output response to exercise were measured as well as flow mediated dilation and pulse wave reactive hyperemia index. Global cognitive function, executive function and verbal learning tests were administered. Linear regression and correlations were performed between cognitive scores, and vascular and autonomic parameters. Microvascular function was inversely related to verbal learning (n=10, r=-0.86, p=0.0013) and executive function (n=11, r=-0.64, p=0.033). Resting cardiac output was associated with verbal learning (n=8, r=0.77, p=0.025). Heart rate during exercise was associated with global function (n=9, r=0.84, p=0.0020). The second minute of heart rate recovery was inversely related to global function (n=9, r=-0.71, p=0.030) and verbal learning (n=8, -0.71, p=0.037). Overall, hypoperfusion and reduced parasympathetic function were predictors of cognitive decline in type 2 diabetes.