[Review in geriatric medicine 2012]

Area of Science:

• Gerontology and Geriatric Medicine
• Neurology
• Endocrinology

Background:

• Evidence suggests exercise compresses morbidity in active older individuals.
• Therapeutic targets for older diabetics, particularly those with cognitive impairment or dementia, warrant revision.
• Alzheimer's disease may exhibit biological and structural abnormalities 25 years prior to clinical onset.

Purpose of the Study:

• To summarize recent findings on exercise benefits in the elderly.
• To discuss revised therapeutic targets for elderly diabetics with cognitive impairment.
• To review advancements in Alzheimer's disease research and dementia treatment.

Main Methods:

• Review of 2012 evidence on exercise and morbidity compression.
• Analysis of studies on glycemic control in older diabetics with cognitive impairment.
• Examination of research on early Alzheimer's disease markers.
• Evaluation of randomized controlled trials (RCTs) for dementia therapeutics.

Main Results:

• Active older persons demonstrated morbidity compression.
• An HbA1c target of 8-9% is suggested as a compromise for older diabetics with cognitive impairment or dementia.
• Alzheimer's-related abnormalities may precede clinical manifestation by 25 years.
• Ginkgo and combination therapy (memantine/donepezil) failed in RCTs; treatment interruption for behavioral symptoms of dementia could be detrimental.

Conclusions:

• Exercise remains crucial for healthy aging and morbidity compression.
• Personalized glycemic targets are essential for elderly diabetics with cognitive decline.
• Early detection of Alzheimer's disease is critical for future interventions.
• Current therapeutic strategies for dementia require further investigation, and treatment interruption should be approached cautiously.