ABSTRACT
Neuropsychology, the study of brain–behavior relationships, has traditionally examined cognitive dysfunction secondary to neurological diseases or psychiatric disorders. With the rise of “medical neuropsychology” as a field of interest, it has become apparent that the structure and function of the central nervous system (CNS) may also be affected by many medical diseases. Diabetes mellitus (DM) has received much attention in that regard and an extensive body of evidence demonstrates that adults with diabetes have an elevated risk of CNS anomalies. The literature on this topic is no longer limited to small cross-sectional studies in relatively selected populations, but now includes larger studies that investigated the pattern and magnitude of neuropsychological decrements and the associated neuroradiological changes in much more detail, with highly sensitive measurements, in both younger and older patients. This chapter reviews this literature and discusses the scientific and clinical implications of these findings. First, the pattern and magnitude of cognitive impairments and structural changes in the brain in patients with pre-diabetic stages and diabetes are discussed. Furthermore, we will highlight several possible risk factors and confounding variables including vascular risk factors, genetics, recurrent hypoglycemia, chronic hyperglycemia, and psychiatric comorbidity. We will discuss the implications of these findings for understanding their effects on daily life and clinical practice.
