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Cognitive function, dementia and type 2 diabetes mellitus in the elderly
Mark W J Strachan1, Rebecca M Reynolds, Riccardo E Marioni
1Metabolic Unit, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK. mark.strachan@nhs.net
Nature Reviews. Endocrinology
|January 26, 2011
Summary
Type 2 diabetes mellitus increases dementia risk. Novel complications like cognitive impairment require new management strategies and inclusion in clinical trials.
Area of Science:
- Neurology
- Endocrinology
- Geriatrics
Background:
- Type 2 diabetes mellitus (T2DM) is increasingly prevalent, with improved management leading to longer lifespans.
- This longevity may reveal novel T2DM complications not addressed by current treatments, such as cognitive impairment.
- T2DM is linked to a 1.5-2.5 times higher risk of dementia.
Purpose of the Study:
- To highlight cognitive impairment and dementia as potential emerging complications of T2DM.
- To emphasize the need to incorporate cognitive function assessment into T2DM clinical trials.
Main Methods:
- Review of existing literature on T2DM and cognitive decline.
- Discussion of potential multifactorial etiologies linking T2DM to dementia.
Main Results:
- Chronic hyperglycemia may contribute to cerebral microvascular disease.
- Severe hypoglycemia in older adults with T2DM could impact brain vulnerability.
- Inflammatory mediators, rheological factors, and HPA axis dysregulation are potential contributors.
Conclusions:
- Cognitive impairment and dementia represent a significant, under-addressed complication of T2DM.
- Cognitive function should be a standard endpoint in T2DM therapeutic intervention trials.
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