Many complications of diabetes, including kidney disease, foot problems and vision problems are generally well recognized. But the disease’s impact on the brain is often overlooked. For the past five years, a team led by Beth Israel Deaconess Medical Center (BIDMC) neurophysiologist Vera Novak, MD, PhD, has been studying the effects of diabetes on cognitive health in older individuals and has determined that memory loss, depression and other types of cognitive impairment are a serious consequence of this widespread disease. Now, Novak’s team has identified a key mechanism behind this course of events. In a study published in the November 2011 issue of the journal Diabetes Care, they report that in older patients with diabetes, two adhesion molecules – sVCAM and sICAM – cause inflammation in the brain, triggering a series of events that affect blood vessels and, eventually, cause brain tissue to atrophy. Importantly, they found that the gray matter in the brain’s frontal and temporal regions — responsible for such critical functions as decision-making, language, verbal memory and complex tasks – is the area most affected by these events. “In fact, at the age of 65, the average person’s brain shrinks about one percent a year, but in a diabetic patient, brain volume can be lowered by as much as 15 percent. Cognitive decline affects a person’s ability to successfully complete even the simplest of everyday tasks, such as walking, talking or writing,” says Novak. “There are currently 25.8 million cases of type 2 diabetes in the United States alone, which is more than eight percent of our total population.