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Left ventricular hypertrophy, brain atrophy and cognitive decline in type 2 diabetes mellitus: Diabetes & Dementia (D2) cohort study
Brodtmann, A.; Patel, S.; Restrepo, C.; Khlif, M. S.; Werden, E.; Ellis, R.; Alsawaf, S.; Ekinci et al.. medRxiv (preprint), 2026-09-02
Topic: Risk, prevention and care in population studies
BACKGROUNDPeople with type 2 diabetes mellitus (T2DM) are at higher risk of cerebral small vessel disease and left ventricular hypertrophy (LVH), potentially contributing to cognitive decline and dementia. At baseline, LVH was associated with female sex, older age, lower educational attainment, lower mood, hypertension, obesity, beta-blocker use, and smaller TBV. Lower educational attainment, hypertension, and lower baseline cognitive scores were associated with cognitive decline. CONCLUSIONSBrain atrophy and cognitive decline were associated with baseline cognitive impairment. We conclude that guideline-directed LVH therapies such as beta-blockers have both cardioprotective (remodelling) and neuroprotective effects. TRIAL REGISTRATIONACTRN12616000546459 UTN: U1111-1181-6659 Clinical perspectiveO_ST_ABSWhat is new?C_ST_ABSO_LICausal inference modelling was used to ask whether left ventricular hypertrophy (LVH) caused increased brain atrophy and cognitive decline over 2 years C_LIO_LILVH reversed in 40% of participants C_LIO_LIIncreased brain atrophy was associated with baseline cognitive impairment C_LIO_LILower educational attainment, baseline cognitive scores and hypertension were associated with cognitive decline C_LIO_LILVH caused less brain atrophy with no effect on cognitive decline C_LI What are the clinical implications?O_LILVH therapies, especially a-blockers, may have both cardioprotective (remodelling) and neuroprotective effects C_LIO_LICognitive impairment in people with T2DM should prompt aggressive risk factor management to prevent brain atrophy and cognitive decline C_LI
Key findings
- BACKGROUNDPeople with type 2 diabetes mellitus (T2DM) are at higher risk of cerebral small vessel disease and left ventricular hypertrophy (LVH), potentially contributing to cognitive decline and dementia.
- At baseline, LVH was associated with female sex, older age, lower educational attainment, lower mood, hypertension, obesity, beta-blocker use, and smaller TBV.
- Lower educational attainment, hypertension, and lower baseline cognitive scores were associated with cognitive decline.
- CONCLUSIONSBrain atrophy and cognitive decline were associated with baseline cognitive impairment.
- We conclude that guideline-directed LVH therapies such as beta-blockers have both cardioprotective (remodelling) and neuroprotective effects.
Why it matters
In this cohort of people with type 2 diabetes, left ventricular hypertrophy was found to cause less brain atrophy over two years with no effect on cognitive decline. The authors suggest guideline-directed left ventricular hypertrophy therapies such as beta-blockers may have neuroprotective effects, but this was not a treatment trial for Alzheimer's disease.
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Study details
- Study designcohort study
- Participants62
- Effect size17.4%
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 38 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for randomised / blinded because the record does not state it. We have no data on impact for its field and year, so that was left out: it earned 36 of the 94 points we could judge it on, which is 38 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv (preprint)) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 1 / 4 | 62 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Louise M. Burrell: h-index 57 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | The University of Melbourne: institution h-index 1,342 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 8 institution(s) in 2 countries |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 36 / 94 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 36 of the 94 points we could judge it on is 38 out of 100. |
| Total | 38 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Brodtmann, A., Patel, S., Restrepo, C., Khlif, M. S., Werden, E., Ellis, R., et al. (2026). Left ventricular hypertrophy, brain atrophy and cognitive decline in type 2 diabetes mellitus: Diabetes & Dementia (D2) cohort study. medRxiv (preprint). https://doi.org/10.64898/2026.08.31.26361868
Vancouver
Brodtmann A, Patel S, Restrepo C, Khlif MS, Werden E, Ellis R, et al. Left ventricular hypertrophy, brain atrophy and cognitive decline in type 2 diabetes mellitus: Diabetes & Dementia (D2) cohort study. medRxiv (preprint). 2026. doi:10.64898/2026.08.31.26361868.
BibTeX
@article{brodtmann2026-52129319,
author = {Brodtmann, A. and Patel, S. and Restrepo, C. and Khlif, M. S. and Werden, E. and Ellis, R. and Alsawaf, S. and Ekinci and others},
title = {{Left ventricular hypertrophy, brain atrophy and cognitive decline in type 2 diabetes mellitus: Diabetes \& Dementia (D2) cohort study}},
journal = {medRxiv (preprint)},
year = {2026},
doi = {10.64898/2026.08.31.26361868},
url = {https://doi.org/10.64898/2026.08.31.26361868}
}
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