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Does Diabetes Increase Your Risk of Alzheimer’s?

Does Diabetes Increase Your Risk of Alzheimer’s?. Samuel Asanad Faye Tager. Background. Type 2 Diabetes Insulin Resistance Reduced ability to use glucose for normal brain function. Background. Brain regions in which lower CMRglu was associated with greater insulin resistance.

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Does Diabetes Increase Your Risk of Alzheimer’s?

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  1. Does Diabetes Increase Your Risk of Alzheimer’s? Samuel Asanad Faye Tager

  2. Background • Type 2 Diabetes • Insulin Resistance • Reduced ability to use glucose for normal brain function

  3. Background Brain regions in which lower CMRglu was associated with greater insulin resistance

  4. Objective • Investigate whether individuals with Alzheimer’s were more likely to have a history of diabetes (I and II) using a nationwide case control study.

  5. Research Design and Methods • Information on reimbursed diabetes medication (type I and II) of all Finnish individuals with reimbursed AD medication in 2005 (n = 28,093) and their AD-free control subjects during 1972–2005. • Obtained from Special Reimbursement Register maintained by Social Insurance Institute of Finland.

  6. Research Design and Methods -Age range: 42-101 years. -Main diagnostic criterion of AD: progressive memory loss, supported by abnormal MRI or cerebrospinal fluid biomarker findings. -Alternatives of memory impairment (severe depression, metabolic disturbances including hyperglycemia), and other forms of dementia (such as vascular dementia) were excluded.

  7. Research Design and Methods • -Study applied age-based classification: • Subjects <40 years diabetes diagnosis classified as T1D. • Those at least 40 years when diagnosed classified as T2D. • -Subjects with diabetes diagnosis <65 years categorized as midlife diabetes. • -Subjects at least 65 years with diabetes diagnosis classified as late-life diabetes.

  8. Results

  9. Results • Assoc. similar with and without CVD • Assoc. similar in both sexes: OR 1.27 and 1.40 • (women and men) • Midlife assoc. > Late life (1.42, 1.05) • Assoc. strengthened after CVD adjustment

  10. Results • AD subjects were younger when diabetes diagnosed (Table 1) so duration of diabetes for case subjects > control subjects.

  11. Conclusions - Mean age of diabetes diagnosis ∼70 years, only 52 of all 6,384 people with diabetes <40 years when diagnosed, suggesting majority had T2D. -Stronger association with midlife diabetes than late-life diabetes. -Shows that long-term diabetes is more strongly associated with cognitive impairment and dementia and that midlife diabetes increases risk of AD

  12. Conclusions --Weakness of Study: Lifestyle or socioeconomic confounders (obesity, smoking, or education not adjusted for). However, study adjusted for CVD. -- Misclassification of people with undetected diabetes or diabetes treated with lifestyle modifications as not having diabetes = underestimation of the association between diabetes and AD.

  13. Conclusions • Strengths of study: • Large sample size • Representativeness • Follow-up length • Verified diagnosis of AD • Included only non-institutionalized people • Access to data collected over 30 years. • -Results suggest individuals with AD are more likely to have a history of diabetes than general older population and association is independent of CVD.

  14. References “History of Medically Treated Diabetes and Risk of Alzheimer Disease in a Nationwide Case-Control Study” http://care.diabetesjournals.org/content/36/7/2015.full “Insulin Resistance and Alzheimer-like Reductions in Regional Cerebral Glucose Metabolism for Cognitively Normal Adults With Prediabetes or Early Type 2 Diabetes” http://archneur.jamanetwork.com/article.aspx?articleid=802106

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