Diabetes in Midlife
Linked to Later Dementia
posted December
09, 2004
Middle-aged people with diabetes are
nearly three times more likely to develop dementia in old age than people
without diabetes.
Dr. Michal Schnaider Beeri, from Mount Sinai School of Medicine in New York,
stated that in looking at a cross-section of the population, studies have "tied
diabetes to Alzheimer's disease or dementia. "Our study is special because it
shows a strong association between these disorders over several decades."
The study involved 2600 subjects who participated in the Israeli Ischemic Heart
Disease study in the 1960s and were still alive and available for follow-up in
1999. The subjects were between 40 and 65 years of age when the study began.
The mental status of 1892 participants was determined, and 652 were identified
as possibly demented. This was confirmed in 309 subjects (16.3 percent).
Those with diabetes during the study were 2.83-times more likely to develop
dementia than those without diabetes, the investigators report in the medical
journal Neurology.
As for how diabetes might promote dementia, Beeri offered three possibilities.
First, excess glucose can create high levels of so-called "advanced glycation
end products," and these have been linked to dementia and Alzheimer's disease in
several studies, she said.
"These end products seem to stick to beta-amyloid and prevent its degradation,"
the researcher explained, referring to the abnormal protein that accumulates in
the brain of people with Alzheimer's disease. Beeri noted that if glycation end
products are involved this could be good news because recent reports suggest
that these levels can be modified by diet.
Another possible explanation is that insulin competes for a degradation enzyme
that also breaks down beta-amyloid, Beeri said. Therefore, with high insulin
levels (as happens with type 2 diabetes), the enzyme is less able to clear away
beta-amyloid.
Or, it may be that diabetes' bad effect on the microcirculation could lead to
dementia by interfering with the brain's blood supply, she added.
Source: Diabetes In Control.com.
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