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Alzheimer's Association International Conference 2026

July 12-15, 2026 | London, United Kingdom, and Online

7024

Higher CGM Variability Is Associated With Lower Gray Matter And Higher White Matter Hyperintensity Volumes: Mesa

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Poster Presenter

Ivan Krizan

Authors

Ivan Krizan

Part of Topic

Title: Higher short-term continuous glucose variability is associated with lower gray matter and higher white matter hyperintensity volumes in older adults: The Multi-Ethnic Study of Atherosclerosis (MESA)

Background:

•Dysglycemia is a well-established risk factor for cognitive decline.

•The association of short-term glucose control with early neuroimaging markers of dementia remains largely unexplored.

Hypothesis:

•Higher continuous glucose variability and higher mean continuous glucose, assessed by continuous glucose monitoring (CGM), are associated with lower total and regional gray matter volumes (GMV) and higher total white matter hyperintensity volume (WMHV).

Methods:

•Outcomes: MESA participants completed 3T brain MRI protocols in 2022-2024 (n=1427) for brain volumes including:

•Total gray matter (GM), frontal lobe GM, temporal lobe GM, limbic GM, total hippocampus GM, and white matter hyperintensities volume (WMHV)

•Exposures: MESA participants completed CGM (n=842) in 2022-2024 with ≥3 days of glucose variability (mean[SD] 11.7 [2.4] days).

•Standard deviation of glucose (SD)

•Coefficient of variation (CV)

•Mean continuous glucose (MEAN)

•Statistics: We report the standardized differences in GMV and log-unit differences in WMHV per two-fold increment in short-term glucose variability (SD, coefficient of variation [CV], mean continuous glucose) with 95% confidence intervals (CI) from multivariable linear regression models adjusted for total intracranial volume, study site, age, sex, race/ethnicity, education, vascular risk factors, and APOE ε4 allele status.

Conclusions:

Higher continuous glucose variability was associated with lower total GMV and higher total WMHV, whereas mean continuous glucose was associated only with total WMHV in a diverse, community dwelling sample of older adults. Associations differed by diabetes status.

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