The association of diabetes and dementia and possible implications for nondiabetic populations

Ravona‐Springer, Ramit; Schnaider‐Beeri, Michal

doi:10.1586/ern.11.152

Cited by 43 publications

(36 citation statements)

References 105 publications

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“…Several mechanisms have been suggested to underlie this association(Ravona-Springer and Schnaider-Beeri, 2011), but no specific mechanism has been determined, hindering the development of dementia prevention strategies in T2D. Degree of glycemic control is a key determinant of micro and macrovascular complications of T2D.…”

Section: Introductionmentioning

confidence: 99%

The ApoE4 genotype modifies the relationship of long-term glycemic control with cognitive functioning in elderly with type 2 diabetes

Ravona‐Springer

Heymann

Schmeidler

et al. 2014

European Neuropsychopharmacology

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Aim To assess whether the APOE4 genotype affects the relationship of long-term glycemic control with cognitive function in elderly with type 2 diabetes (T2D). Methods Participants were cognitively normal and pertained to a Diabetes Registry which provided access to HbA1c levels and other T2D related factors since 1998. Glycemic control was defined as the mean of all HbA1c measurements available (averaging 18 measurements) per subject. Four cognitive domains (episodic memory, semantic categorization, attention/working memory and executive function), based on factor analysis and an overall cognitive score (the sum of the 4 cognitive domains) were the outcome measures. Results The analysis included 808 subjects; 107 (11.9%) subjects had ≥1ApoE4 allele. In ApoE4 carriers, higher mean HbA1c level was significantly associated with lower scores on all cognitive measures except attention/working memory (p-values ranging from 0.047 to 0.003). In ApoE4 noncarriers, higher mean HbA1c level was significantly associated with lower scores on executive function, but not with other cognitive measures—despite the larger sample size. Compared to non- carriers, there were significantly stronger associations in ApoE4 carriers for overall cognition (p=0.02), semantic categorization (p=0.03) and episodic memory (p=0.02), and the difference for executive function approached statistical significance (p=0.06). Conclusion In this cross-sectional study of cognitively normal T2D subjects, higher mean HbA1c levels were generally associated with lower cognitive performance in ApoE4 carriers, but not in non-carriers, suggesting that ApoE4 affects the relationship between long-term glycemic control and cognition, so APOE4 carriers may be more vulnerable to the insults of poor glycemic control.

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Section: Introductionmentioning

confidence: 99%

The ApoE4 genotype modifies the relationship of long-term glycemic control with cognitive functioning in elderly with type 2 diabetes

Ravona‐Springer

Heymann

Schmeidler

et al. 2014

European Neuropsychopharmacology

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“…En la literatura científica se recoge la asociación entre el diagnóstico de DM2 en adultos mayores y un mayor riesgo de desarrollar algún tipo de trastorno cognitivo (Cholerton, Baker, y Craft, 2011;Donohoe, y Benton, 2000;Nilsson, 2006;Ravona-Springer, y Schnaider-Beeri, 2011;Redondo, Reales, y Ballesteros, 2010; Salinas-Contreras, Hiriart-Urdanivia, AcostaCastillo, y Sosa-Ortiz, 2013). Sabemos también que las alteraciones de la síntesis de glucosa afectan al funcionamiento de la memoria (Donohoe et al, 2000), que los trastornos en la glucorregulación producen efectos de degeneración neuronal (Ramasamy et al, 2005) y que la diabetes tipo 2 puede causar atrofia corticosubcortical moderada, un aumento paulatino de las hiperintensidades en la sustancia blanca y deficiencias en la conducción de señales en el Sistema Nervioso Central (Arvanitakis, Wilson, Bienias, Evans, y Bennett, 2004;Awad, Gagnon, y Messier, 2004;Gispen, y Biessels, 2000;Greg, y Brown 2003;Redondo et.…”

Section: Introductionunclassified

Entrenamiento de la memoria en personas mayores con diabetes mellitus tipo 2. / Memory training in older people with type 2 diabetes mellitus.

Lancho¹,

Esteban²,

Mateos³

et al. 2017

PSYE

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RESUMENLas enfermedades metabólicas en los ancianos están asociadas con un mayor riesgo de desarrollar alguna disfunción cognitiva. Este estudio investigó el efecto del entrenamiento en estrategias de memoria en adultos mayores con diabetes mellitus tipo 2, siguiendo un diseño semiexperimental. Participaron en el estudio 11 personas que padecían diabetes mellitus tipo 2, sin deterioro cognitivo, ansiedad ni depresión. Su función mnésica fue medida antes y después de la implementación del programa. Los resultados mostraron diferencias significativas en la tarea de Memoria de Textos Inmediata, Evocada por Preguntas. Al analizar el tamaño del efecto se observó un aumento del rendimiento en tareas de Memoria de Textos Inmediata y Memoria de Textos Diferida. En un análisis ideográfico se observó que los pacientes con puntuaciones más altas en ansiedad y depresión y con puntuaciones más bajas en las pruebas de memoria pretest mostraron una mejoría clínica en memoria. Se puede concluir que los adultos mayores diabéticos, propensos a desarrollar déficits mnésicos, pueden beneficiarse de un programa de estimulación de la memoria. Destacamos que el 89,1% de los sujetos diabéticos seleccionados inicialmente para el estudio cumplían alguno de los criterios de exclusión y no pudieron participar en el programa. Por ello se plantea la posibilidad de replicar el estudio con muestras más amplias. ABSTRACTMetabolic diseases in older people are associated with an increased risk of developing some cognitive dysfunction. This study investigated the effect of training on memory strategies in older people with type 2 diabetes mellitus following a semiexperimental design. Eleven patients with diabetes mellitus type 2, without cognitive impairment, anxiety nor depression, participated in the study. Measurements of their mnesic function were taken before and after implementation of the program. The results showed significant differences in Immediate Text Memory Task, Evoked by Clues. By analyzing the effect size, an increased performance in Immediate and Delayed Text Memory Tasks is observed. In an idiographic analysis, it was observed that patients with higher scores in anxiety and depression and with low scores in the pretest memory tasks showed a greater clinical improvement in memory. It can be concluded that older diabetics, prone to developing mnesic deficits, may benefit from a program of memory stimulation. We emphasize that 89.1% of the diabetic subjects initially selected for the study met some of the exclusion criteria and were not able to participate in the program. Therefore, the possibility to extend the study with larger samples is raised.

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“…Elderly individuals with type 2 diabetes are at increased risk for cognitive compromise and dementia, including vascular dementia and Alzheimer's disease (AD) [1][2][3][4][5], with genetic factors and poor management of type 2 diabetes among possible underlying causes. With the elderly population being the fastest growing segment of the population [6] and the accelerating rates of both type 2 diabetes [7,8] and dementia [9,10], better understanding of known and novel mechanisms that may affect cognition in type 2 diabetes is imperative for enhancement of public health.…”

Section: Introductionmentioning

confidence: 99%

P3‐250: Haptoglobin genotype modulates the relationships of glycaemic control with cognitive function in elderly individuals with type 2 diabetes

Guerrero‐Berroa

Ravona‐Springer

Heymann

et al. 2015

Alzheimer's & Dementia

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Aims/hypothesis-The purpose of this study was to investigate whether the association of glycaemic control with cognitive function is modulated by the haptoglobin 1-1 (Hp 1-1) genotype in cognitively normal elderly with type 2 diabetes.Methods-In this cross-sectional study, we examined 793 participants who were genotyped for Hp (80 Hp 1-1 carriers and 713 Hp 1-1 non-carriers) enrolled in the Israel Diabetes and Cognitive Decline (IDCD) study. Glycaemic control was operationally defined by HbA 1c level. The outcome measures were performance in four cognitive domains (episodic memory, attention/working memory, language/semantic categorisation, executive function) and overall cognition, a composite of the domains. Effect sizes were obtained from hierarchical linear regression analyses for each outcome measure, controlling for demographics, type 2 diabetes-related characteristics, cardiovascular risk factors, and their interactions with Hp genotype.Results-Interaction analyses showed significantly stronger associations of HbA 1c with poorer cognitive function among Hp 1-1 carriers than non-carriers; attention/working memory (p < 0.001)Corresponding author: Elizabeth Guerrero-Berroa, James J. Peters VA Medical Center, 130 West Kingsbridge Road, Room 1F-01, Bronx, NY 10468, USA elizabeth.guerrero-berroa@mssm.edu. Contribution statement MSB led the development of the study design. RRS and AH collaborated in planning the study design. MSB, RRS, AH and AL contributed to the data research. MSB, RRS and AH contributed to data collection. JS performed the statistical analysis. EGB conducted the literature search and wrote the manuscript. MSB and JS contributed to the writing of the manuscript. All coauthors contributed to the interpretation of results, critically revised the manuscript and gave final approval. EGB is the guarantor of this work. Duality of interestThe authors declare that there is no duality of interest associated with this study. and overall cognition (p = 0.003). For these two cognitive domains, associations were significant for Hp 1-1 carriers despite the small sample size (p < 0.00001 and p = 0.001, respectively), but not for non-carriers. HHS Public AccessConclusions/interpretation-Our findings suggest that patients with type 2 diabetes and poor glycaemic control carrying the Hp 1-1 genotype may be at increased risk of cognitive impairment, particularly in the attention/working memory domain. The association of glycaemic control with this domain may indicate cerebrovascular mechanisms.

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The association of diabetes and dementia and possible implications for nondiabetic populations

Cited by 43 publications

References 105 publications

The ApoE4 genotype modifies the relationship of long-term glycemic control with cognitive functioning in elderly with type 2 diabetes

The ApoE4 genotype modifies the relationship of long-term glycemic control with cognitive functioning in elderly with type 2 diabetes

Entrenamiento de la memoria en personas mayores con diabetes mellitus tipo 2. / Memory training in older people with type 2 diabetes mellitus.

P3‐250: Haptoglobin genotype modulates the relationships of glycaemic control with cognitive function in elderly individuals with type 2 diabetes

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