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Diabetes Doubles Alzheimer's Risk
By Anne Harding, Health.com: People with diabetes are at increased risk of having a heart attack or
stroke at an early age. But
that’s not the only worry: Diabetes appears to dramatically increase a person’s
risk of developing Alzheimer’s
disease or other types of dementia later in life, according to a new study
conducted in Japan.
In the study, which included more than 1,000 men and women over age 60,
researchers found that people with diabetes were twice as likely as the other
study participants to develop Alzheimer’s disease within 15 years. They were
also 1.75 times more likely to develop dementia of any kind.
“It’s really important for the public health to understand that diabetes is a
significant risk factor for all of these types of dementia,” says Rachel Whitmer,
PhD, an epidemiologist in the
research division of Kaiser Permanente Northern California, a nonprofit
health-care organization based in Oakland, Calif.
Whitmer, who studies risk factors for Alzheimer’s but wasn’t involved in the
new research, stresses that many questions remain about the link between
diabetes and dementia. The new study was “well done” and provides “really good
evidence that people with diabetes are at greater risk,” she says, “but we
really need to look at other studies to find out why.”
What Factors Increase the Risk?
Diabetes could contribute to dementia in several ways, which researchers are
still sorting out. Insulin
resistance, which causes high blood sugar and in some cases leads to
type 2 diabetes, may interfere with
the body’s ability to break down a protein (amyloid) that forms brain plaques
that have been linked to Alzheimer’s. High blood sugar (glucose) also produces
certain oxygen-containing molecules that can damage cells, in a process known as
oxidative stress.
In addition, high blood sugar—along with high cholesterol—plays a role in the
hardening and narrowing of arteries in the brain. This condition, known as
atherosclerosis, can bring
about vascular dementia, which occurs when artery blockages (including strokes)
kill brain tissue.
“Having high glucose is a stressor to the nervous system and to the blood
vessels,” says David Geldmacher, MD, a professor of neurology at the University
of Alabama at Birmingham. “The emerging information on Alzheimer’s disease and
glucose shows us that we do need to remain vigilant on blood sugar levels as we
get older.”
New and Improved Research
Studies dating back to the late 1990s have suggested that people with
diabetes are more likely to develop Alzheimer’s disease and other types of
dementia, but the research has been marred by inconsistent definitions of both
diabetes and dementia.
The authors of the new study, led by Yutaka Kiyohara, MD, an environmental
medicine researcher at Kyushu University, in Fukuoka, sought to address this
weakness by using the gold standard of diabetes diagnosis, an oral glucose
tolerance test. This involves giving a person a sugar-loaded drink after they
have fasted for at least 12 hours, and then measuring how much glucose remains
in their blood two hours later.
At the beginning of the study, the tests showed that 15% of the participants
had full-fledged diabetes, while 23% had prediabetes, also known as impaired
glucose tolerance.
During the next 15 years, 23% of the participants received a dementia
diagnosis. Slightly less than half of those cases were deemed to be Alzheimer’s
disease, with the remainder roughly split between vascular dementia and dementia
due to other causes. (The diagnoses were confirmed with brain scans of living
patients and brain autopsies in
deceased patients.)
The link between diabetes and dementia risk persisted even after the
researchers took into account several factors associated with both diabetes and
dementia risk, such as age, sex, blood pressure, and body mass index.
The next step in the research, Whitmer says, will be to understand whether
controlling blood sugar and reducing risk factors for type 2 diabetes also
reduces dementia risk. She and her colleagues have several studies underway
investigating these questions.
courtesy: http://health.yahoo.net/
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