User login
Patients with type 2 diabetes are at risk for amnestic mild cognitive impairment, which is thought to be a precursor of Alzheimer's disease, reported Dr. José A. Luchsinger and his associates at Columbia University, New York.
Diabetes is known to raise the risk of Alzheimer's disease (AD), but its relation to mild cognitive impairment (MCI) has not been established until now. Some researchers and physicians have described mild cognitive impairment, particularly amnestic MCI, as a transitional state between normal cognition and AD, the investigators wrote.
Dr. Luchsinger and his associates studied the relationship between diabetes and MCI using data from a longitudinal cohort study of 918 Medicare recipients residing in New York City. Baseline data were collected from 1992 to 1994, and the subjects were followed every 18 months until 2003. They underwent extensive physical and neurologic examinations, including a battery of neuropsychological testing that assessed learning, memory, orientation, abstract reasoning, language, and visuospatial ability.
Seventy percent of the study population was women, and the mean age was 76 years. The study group was 44% Hispanic, 34% African American, and 22% white. Twenty-four percent of the subjects reported having diabetes.
Cognitive impairment was diagnosed by a consensus of two neurologists, one psychiatrist, and two neuropsychologists. A total of 334 cases of MCI developed during follow-up, including 160 cases of amnestic MCI.
Diabetes was significantly related to MCI of any cause, and even more strongly related to amnestic MCI, even after the data were adjusted to account for subject age, sex, ethnicity, years of education, stroke history, hypertension, heart disease, smoking, and apolipoprotein E gene status.
The calculated risk of MCI attributable to diabetes was 9% for the overall study population, 8% for African Americans, 11% for Hispanics, and 5% for whites, “reflecting the differences in diabetes prevalence by ethnic group,” the investigators noted (Arch. Neurol. 2007;64:570–5).
“Diabetes could be related to a higher risk of AD and amnestic MCI through direct mechanisms, affecting the amyloid accumulation that is the putative culprit of AD, or indirect mechanisms, namely cerebrovascular disease,” Dr. Luchsinger and his associates wrote.
However, their results suggested that the association is independent of cerebrovascular disease.
“Hyperinsulinemia … may disrupt brain amyloid b clearance by means of the insulin degrading enzyme. Another potential mechanism is the generation of advanced products of glycosylation,” the researchers added.
Patients with type 2 diabetes are at risk for amnestic mild cognitive impairment, which is thought to be a precursor of Alzheimer's disease, reported Dr. José A. Luchsinger and his associates at Columbia University, New York.
Diabetes is known to raise the risk of Alzheimer's disease (AD), but its relation to mild cognitive impairment (MCI) has not been established until now. Some researchers and physicians have described mild cognitive impairment, particularly amnestic MCI, as a transitional state between normal cognition and AD, the investigators wrote.
Dr. Luchsinger and his associates studied the relationship between diabetes and MCI using data from a longitudinal cohort study of 918 Medicare recipients residing in New York City. Baseline data were collected from 1992 to 1994, and the subjects were followed every 18 months until 2003. They underwent extensive physical and neurologic examinations, including a battery of neuropsychological testing that assessed learning, memory, orientation, abstract reasoning, language, and visuospatial ability.
Seventy percent of the study population was women, and the mean age was 76 years. The study group was 44% Hispanic, 34% African American, and 22% white. Twenty-four percent of the subjects reported having diabetes.
Cognitive impairment was diagnosed by a consensus of two neurologists, one psychiatrist, and two neuropsychologists. A total of 334 cases of MCI developed during follow-up, including 160 cases of amnestic MCI.
Diabetes was significantly related to MCI of any cause, and even more strongly related to amnestic MCI, even after the data were adjusted to account for subject age, sex, ethnicity, years of education, stroke history, hypertension, heart disease, smoking, and apolipoprotein E gene status.
The calculated risk of MCI attributable to diabetes was 9% for the overall study population, 8% for African Americans, 11% for Hispanics, and 5% for whites, “reflecting the differences in diabetes prevalence by ethnic group,” the investigators noted (Arch. Neurol. 2007;64:570–5).
“Diabetes could be related to a higher risk of AD and amnestic MCI through direct mechanisms, affecting the amyloid accumulation that is the putative culprit of AD, or indirect mechanisms, namely cerebrovascular disease,” Dr. Luchsinger and his associates wrote.
However, their results suggested that the association is independent of cerebrovascular disease.
“Hyperinsulinemia … may disrupt brain amyloid b clearance by means of the insulin degrading enzyme. Another potential mechanism is the generation of advanced products of glycosylation,” the researchers added.
Patients with type 2 diabetes are at risk for amnestic mild cognitive impairment, which is thought to be a precursor of Alzheimer's disease, reported Dr. José A. Luchsinger and his associates at Columbia University, New York.
Diabetes is known to raise the risk of Alzheimer's disease (AD), but its relation to mild cognitive impairment (MCI) has not been established until now. Some researchers and physicians have described mild cognitive impairment, particularly amnestic MCI, as a transitional state between normal cognition and AD, the investigators wrote.
Dr. Luchsinger and his associates studied the relationship between diabetes and MCI using data from a longitudinal cohort study of 918 Medicare recipients residing in New York City. Baseline data were collected from 1992 to 1994, and the subjects were followed every 18 months until 2003. They underwent extensive physical and neurologic examinations, including a battery of neuropsychological testing that assessed learning, memory, orientation, abstract reasoning, language, and visuospatial ability.
Seventy percent of the study population was women, and the mean age was 76 years. The study group was 44% Hispanic, 34% African American, and 22% white. Twenty-four percent of the subjects reported having diabetes.
Cognitive impairment was diagnosed by a consensus of two neurologists, one psychiatrist, and two neuropsychologists. A total of 334 cases of MCI developed during follow-up, including 160 cases of amnestic MCI.
Diabetes was significantly related to MCI of any cause, and even more strongly related to amnestic MCI, even after the data were adjusted to account for subject age, sex, ethnicity, years of education, stroke history, hypertension, heart disease, smoking, and apolipoprotein E gene status.
The calculated risk of MCI attributable to diabetes was 9% for the overall study population, 8% for African Americans, 11% for Hispanics, and 5% for whites, “reflecting the differences in diabetes prevalence by ethnic group,” the investigators noted (Arch. Neurol. 2007;64:570–5).
“Diabetes could be related to a higher risk of AD and amnestic MCI through direct mechanisms, affecting the amyloid accumulation that is the putative culprit of AD, or indirect mechanisms, namely cerebrovascular disease,” Dr. Luchsinger and his associates wrote.
However, their results suggested that the association is independent of cerebrovascular disease.
“Hyperinsulinemia … may disrupt brain amyloid b clearance by means of the insulin degrading enzyme. Another potential mechanism is the generation of advanced products of glycosylation,” the researchers added.