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Salivary amyloid β42 levels in mild cognitive impairment among aged diabetics
Doha Rasheedy1, Nermien Naim Adly2, Ramy Mahdy Ahmed3
1Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. doharasheedy@yahoo.com.
Purpose:
The underlying pathology for cognitive decline in diabetic patients is uncertain. It was originally linked to vascular causes; however, possible contribution of Alzheimer's pathology was debated. This study explored the link between salivary amyloid β42 level (as a surrogate marker for Alzheimer's pathology) and mild cognitive impairment (MCI) among old diabetic patients.
Methods:
A case-control study included 90 diabetic participants, ≥ 60 years of age, divided into 45 cases with MCI and 45 controls. Patients with history of head trauma, any central nervous system pathology, depression, dementia or delirium, those who received anticholinergic drugs, or refused to participate in the study were excluded. Assessment of the relationship between salivary Aβ42 level and neuropsychological performance was done using a battery consisting of the logical memory test, forward and backward digit span tests, category fluency test, go/no go test, stick design test, and second-order belief.
Results:
Salivary Aβ42 levels were higher in MCI diabetics versus controls (P = 0.014), it predicted MCI among aged diabetics, even after adjustment for confounding vascular risk factors. Salivary Aβ42 had moderate accuracy to identify MCI (area under curve = 0.654, P = 0.008). At cut-off ≥ 47.5 pg/ml, sensitivity, specificity, positive predictive value and negative predictive value were 80%, 47%, 60% and 70%, respectively.
Conclusion:
Current data support that MCI in diabetics, without CNS disorders, is associated with a surrogate marker of Alzheimer's pathology.
Insights
Diabetic patients with mild cognitive impairment (MCI) show higher levels of salivary amyloid beta 42 (Aβ42), a marker for Alzheimer's pathology. This finding suggests a link between Alzheimer's and cognitive decline in older diabetics.
Area of Science:
- Neurology
- Endocrinology
- Geriatrics
Background:
- Cognitive decline in diabetic patients has uncertain underlying pathology, with debates on vascular versus Alzheimer's disease contributions.
- Alzheimer's pathology is increasingly considered a potential factor in diabetic cognitive impairment.
Purpose of the Study:
- To investigate the association between salivary amyloid beta 42 (Aβ42) levels and mild cognitive impairment (MCI) in elderly diabetic patients.
- To evaluate salivary Aβ42 as a potential biomarker for Alzheimer's pathology in diabetic individuals experiencing cognitive decline.
Main Methods:
- A case-control study involving 90 diabetic participants aged 60 years and above, with 45 diagnosed with MCI and 45 as controls.
- Exclusion criteria included history of head trauma, central nervous system pathology, depression, dementia, delirium, or use of anticholinergic drugs.
- Neuropsychological assessment utilized a battery of tests including logical memory, digit span, category fluency, go/no go, stick design, and second-order belief.
Main Results:
- Salivary Aβ42 levels were significantly higher in diabetic patients with MCI compared to controls (P=0.014).
- Elevated salivary Aβ42 levels predicted MCI in aged diabetics, independent of vascular risk factors.
- The biomarker demonstrated moderate accuracy in identifying MCI, with an area under the curve of 0.654 (P=0.008).
Conclusions:
- The study supports the association of MCI in diabetic patients (without CNS disorders) with a surrogate marker of Alzheimer's pathology.
- Salivary Aβ42 may serve as a valuable, non-invasive biomarker for detecting Alzheimer's-related changes contributing to cognitive decline in diabetes.
