Diabetes and Dementia: A Retrospective Neuropathologic Study of Old Diabetics Compared to Non-Diabetic Controls

  • Jean-Pierre Michel
  • Pius Muller
  • Gabriel Gold
  • Willliam Mac Gee
  • Reihnild Mulligan
  • Constantin Bouras
Part of the Advances in Alzheimer Disease Therapy book series (AADT)

Abstract

Non-insulin-dependent diabetes mellitus (NIDDM) and dementia are both characterized by high prevalence in later life (Muller, 1993). Differences in prevalence of NIDDM according to regions and races are well-known. In an industrialized society, with a predominantly white population, the rate of NIDDM increases linearly starting from 35 years old, reaching 15% at the age of 75 (Wilson et al., 1986) and 20% at the age of 80 (Morley and Perry, 1991). As for Alzheimer’s Disease (AD), it follows an exponential curve starting from the age of 50, reaching 30% for the 85 year-old population (Skoog et al., 1993).

Keywords

Creatinine Dementia Acetyl Hyperglycemia Hypoglycemia 

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References

  1. Blessed G (1990): Definition and classification of the dementias: the point of view of a clinician. In: Innovative Trends in Psychogeriatrics, Interdiscipl Top in Gerontol. Wertheimer J, Bauman P, Gaillard M, Schwed P eds. Basel: Karger pp 63–9.Google Scholar
  2. Bouras C, Hof P (1992): Neuropathologie de la maladie d’Alzheimer In: Editions techniques. Enc Med Chir Psychiatr 37280 A20.Google Scholar
  3. Bucht G, Adolfsson R, Lithner et al. (1983): Changes in blood glucose and insulin secretion in patients with senile dementia of Alzheimer type. Acta Med Scand 213: 387–92.PubMedCrossRefGoogle Scholar
  4. Craft S, Dagogo-Jack SE, Wiethop B et al. (1993): The effects of hyperglycemia on memory hormone levels in dementia of the Alzheimer type: a longitudinal study. Behav Neurosci 107:223–7.CrossRefGoogle Scholar
  5. Craft S, Newcomer J, Kanne S et al. (1996): Memory improvement following induced hyperinsulinemia in AD. Neurobiol Aging 17:123–30.PubMedCrossRefGoogle Scholar
  6. Croxon SCM, Jagger C (1995): Diabetes and cognitive impairment: a community-based study of elderly subjects Age Aging 24:421–4.CrossRefGoogle Scholar
  7. Gradman TJ, Laws A, Thompson LW et al. (1993): Verbal learning and/or memory improves with glycemic control in older subjects with non-insulin-dependent diabetes mellitus J Am Geriatr Soc 41:1305–12.PubMedGoogle Scholar
  8. Lanvin K, Blennow K, Wallin A et al. (1993): Low blood pressure and blood glucose levels in AD: Evidence for a hypometabolic disorder? J Internal Med 233: 357–63.CrossRefGoogle Scholar
  9. Mattlar CE, Falck B, Rônnema T et al. (1985): Neuropsychological cognitive performance of patients with type II diabetes. Scand J Rehab Med 17:101–5.Google Scholar
  10. Meneilly GS, Cheung E, Tessier et al. (1993): The effects of improved glycemic control on cognitive functions in the elderly patient with diabetes. J Gerontol 48: Ml17–21.Google Scholar
  11. Morley J, Perry HM (1991): The management of diabetes mellitus in older individuals. Drugs 41:548–65.PubMedCrossRefGoogle Scholar
  12. Mortel KF, Wood S, Pavol MA et al. (1993): Analysis of familial and individual risk factors among patients with ischemic vascular dementia and AD. Angiology 44:599–605.PubMedCrossRefGoogle Scholar
  13. Mooradian AD, Perryman K, Fitten J et al. (1988): Cortical function in elderly non insulin dependent diabetic patients. Arch Intern Med 148:2369–72.PubMedCrossRefGoogle Scholar
  14. Muller PJ (1993): Neuropathologie cérébrale des diabétiques âgés Thèse doctorat en médecine, Faculté de Médecine de Genève N°9477.Google Scholar
  15. Nielson KA, Nolan JH, Berchtold NC et al. (1996): Apolipoprotein-E genotyping of diabetic dementia patients: is diabetes rare in Alzheimer disease? J Am Geriatr Soc (in press).Google Scholar
  16. Perlmutter LC, Hakami MK, Hodgson-Harrington C et al. (1984): Decreased cognitive function in aging non-insulin dependent diabetic patients. Am J Med 77:1043–8.CrossRefGoogle Scholar
  17. Polonsky KS, Sturis J, Bell GI (1996): Non-insulin-dependent diabetes: a genetically programmed failure of the beta cell to compensate for insulin resistance. New Engl J Med 334:777–83.PubMedCrossRefGoogle Scholar
  18. Reaven GM, Thompson LW, Nahum D et al. (1990): Relationship between hyperglycemia and cognitive function in older NIDDM patients. Diabetes Care 13:16–21.PubMedCrossRefGoogle Scholar
  19. Rieman EM, Caselli RJ, Yun LS et al. (1996): Preclinical evidence of AD in persons homozygous for the ε4 allele for apolipoprotein E. New Engl J Med; 334:752–8.CrossRefGoogle Scholar
  20. Schwartz MW, Figlewicz DP, Baskin DG (1989): Insulin in the brain: a hormonal regulator of energy balance. Mol Neurobiol 3:71–5.CrossRefGoogle Scholar
  21. Skoog I, Nilsson L, Palmertz B et al. (1993): A population-based study of dementia in 85-year-olds. New Engl J Med 328:153–8.PubMedCrossRefGoogle Scholar
  22. Small GW, Rosenthal MJ (1992): Coexistence of AD and diabetes mellitus. J Am Geriatr Soc 40:1075–6.PubMedGoogle Scholar
  23. Soininen H, Puranen M, Helkala EL et al. (1992): Diabetes mellitus and brain atrophy: a computed tomography study in an elderly population. Neurobiol Aging 13:717–21.PubMedCrossRefGoogle Scholar
  24. Tun PA, Nathan DM, Perlmuter LC (1990): Diabetes mellitus in the elderly: cognitive and affective disorders in elderly diabetics. Clinics Geriatr 6:731–46.Google Scholar
  25. Ulrich J, Probst A, Wüest M (1986): The brain diseases causing senile dementia. A morphological study on 54 consecutive autopsy cases. J Neurol 233:118–22.PubMedCrossRefGoogle Scholar
  26. Unger J, McNeill T, Moxley RT III et al. (1989): Distribution of insulin receptor-like immunoreactivity in the rat forebrain. Neurosci 3:143–5.CrossRefGoogle Scholar
  27. U’Ren RC, Riddle MC, Lezack MD et al. (1990): The mental efficiency of the elderly person with type II diabetes mellitus. J Am Geriatr Soc 38:505–10.PubMedGoogle Scholar
  28. Wade JPH, Hachinski VC (1987): Multi-infarct dementia In: Dementia. Churchill, Livingstone, Edinburgh, eds. PITT B 209–28.Google Scholar
  29. WHO (1985): Diabetes mellitus. Technical report 727, WHO Geneva.Google Scholar
  30. Wilson PW, Keaven M, Anderson PD (1986): Epidemiology of diabetes mellitus in the elderly. The Framingham study. Am J Med 80 suppl 5A:3–9.PubMedCrossRefGoogle Scholar
  31. Wolf-Klein GP, Silverstone FA, Brod MS et al. (1988): Are Alzheimer patients healthier? J Am Geriatr Soc 36:219–24.PubMedGoogle Scholar
  32. Worrall G, Moulton N, Briffett E (1993): Effect of type II diabetes mellitus on cognitive function. J Family Practice 36:639–43.Google Scholar

Copyright information

© Birkhäuser Boston 1997

Authors and Affiliations

  • Jean-Pierre Michel
    • 1
  • Pius Muller
    • 1
  • Gabriel Gold
    • 1
  • Willliam Mac Gee
    • 1
  • Reihnild Mulligan
    • 1
  • Constantin Bouras
    • 2
  1. 1.Department of GeriatricsUniversity Hospitals of GenevaThônex-GenevaSwitzerland
  2. 2.Neuropathology Division, Department of PsychiatryUniversity Hospitals of GenevaThônex-GenevaSwitzerland

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