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An Update on Type 2 Diabetes Mellitus as a Risk Factor for Dementia
1Master of Physician Assistant Studies, School of Health and Rehabilitation Sciences, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
Journal of Alzheimer'S Disease : JAD
|May 11, 2016
Summary
Type 2 diabetes mellitus (T2DM) elevates dementia risk, particularly Alzheimer's disease and vascular dementia. Tau tangles, not amyloid plaques, are key biomarkers, with neuron damage and impaired blood flow contributing to cognitive decline.
Area of Science:
- Neuroscience
- Endocrinology
- Geriatrics
Background:
- Growing evidence links type 2 diabetes mellitus (T2DM) to brain changes.
- Understanding T2DM's association with dementia and its mechanisms is crucial.
Purpose of the Study:
- To review and synthesize current evidence on the relationship between T2DM and dementia.
- To explore the pathophysiological mechanisms underlying T2DM-associated cognitive impairment.
Main Methods:
- Literature search conducted in Medline, EMBASE, and Google Scholar.
- Included human studies focusing on T2DM and dementia/cognitive impairment.
- Excluded studies on type 1 diabetes mellitus (T1DM) or non-classified diabetes.
Main Results:
- T2DM is a risk factor for vascular dementia (VaD) and Alzheimer's disease (AD).
- T2DM interacts with age, hypertension, cholesterol, and APOEɛ4 status to worsen cognition.
- Comorbid T2DM exacerbates clinical presentations of AD and VaD.
- Tau-related neurofibrillary tangles appear more significant than amyloid-β plaques in T2DM-related dementia.
Conclusions:
- T2DM increases dementia risk through distinct and overlapping mechanisms for AD and VaD.
- Neuron degeneration, impaired cerebral blood supply/metabolism, and genetic factors are implicated.
- Tau pathology is a likely biomarker for T2DM-associated dementia.
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