Prediabetes, intervening diabetes and subsequent risk of dementia: the Atherosclerosis Risk in Communities (ARIC) study

Hu, Jiaqi; Fang, Michael; Pike, James R; Lutsey, Pamela L.; Sharrett, A. Richey; Wagenknecht, Lynne E.; Hughes, Timothy M.; Seegmiller, Jesse C.; Gottesman, Rebecca F.; Mosley, Thomas H.; Coresh, Josef; Selvin, Elizabeth

doi:10.1007/s00125-023-05930-7

Cited by 13 publications

(7 citation statements)

References 34 publications

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“…Cardiovascular risk specific factors associated with cognitive frailty in this study included high fasting blood sugar and hypertension. High blood glucose levels, as seen in individuals with diabetes or prediabetes, may contribute to accumulation of amyloid plaques and tau tangles in the brain[ 38 , 39 ]. Furthermore, insulin resistance, often associated with elevated blood glucose levels, can impair the brain ability to utilize glucose for energy[ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular risk factors among older persons with cognitive frailty in middle income country

Ibrahim,

Singh,

Ludin

et al. 2024

World J Clin Cases

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BACKGROUND Cognitive frailty, characterized by the coexistence of cognitive impairment and physical frailty, represents a multifaceted challenge in the aging population. The role of cardiovascular risk factors in this complex interplay is not yet fully understood. AIM To investigate the relationships between cardiovascular risk factors and older persons with cognitive frailty by pooling data from two cohorts of studies in Malaysia. METHODS A comprehensive approach was employed, with a total of 512 community-dwelling older persons aged 60 years and above, involving two cohorts of older persons from previous studies. Datasets related to cardiovascular risks, namely sociodemographic factors, and cardiovascular risk factors, including hypertension, diabetes, hypercholesterolemia, anthropometric characteristics and biochemical profiles, were pooled for analysis. Cognitive frailty was defined based on the Clinical Dementia Rating scale and Fried frailty score. Cardiovascular risk was determined using Framingham risk score. Statistical analyses were conducted using SPSS version 21. RESULTS Of the study participants, 46.3% exhibited cognitive frailty. Cardiovascular risk factors including hypertension (OR:1.60; 95%CI: 1.12-2.30), low fat-free mass (OR:0.96; 95%CI: 0.94-0.98), high percentage body fat (OR:1.04; 95%CI: 1.02-1.06), high waist circumference (OR:1.02; 95%CI: 1.01-1.04), high fasting blood glucose (OR:1.64; 95%CI: 1.11-2.43), high Framingham risk score (OR:1.65; 95%CI: 1.17-2.31), together with sociodemographic factors, i.e. , being single (OR 3.38; 95%CI: 2.26-5.05) and low household income (OR 2.18; 95%CI: 1.44-3.30) were found to be associated with cognitive frailty. CONCLUSION Cardiovascular-risk specific risk factors and sociodemographic factors were associated with risk of cognitive frailty, a prodromal stage of dementia. Early identification and management of cardiovascular risk factors, particularly among specific group of the population might mitigate the risk of cognitive frailty, hence preventing dementia.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular risk factors among older persons with cognitive frailty in middle income country

Ibrahim,

Singh,

Ludin

et al. 2024

World J Clin Cases

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“…This result, however, needs to be weighed against the evidence emerging from other studies showing a positive association between diabetes and late-onset dementia, and a higher risk of developing dementia when individuals were affected at a young age, regardless of its subtype. More specifically, research suggests that an earlier onset of diabetes is linked with a higher risk of dementia [ 56 ], and that the risk of AD is higher among people with diabetes than in the general population, irrespective of the age of onset [ 57 ]. Concerning diabetes, various studies have suggested that it has a role in increasing the risk of developing vascular dementia and AD, perhaps due to direct effects of the intrinsic metabolic conditions in diabetes (e.g., hyperglycemia and hyperinsulinemia) or through the mediating effect of other disorders [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Atrial Fibrillation and Other Cardiovascular Factors and the Risk of Dementia: An Italian Case–Control Study

Mazzoli,

Chiari,

Vitolo

et al. 2024

IJERPH

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Dementia is a major neurologic syndrome characterized by severe cognitive decline, and it has a detrimental impact on overall physical health, leading to conditions such as frailty, changes in gait, and fall risk. Depending on whether symptoms occur before or after the age of 65, it can be classified as early-onset (EOD) or late-onset (LOD) dementia. The present study is aimed at investigating the role of cardiovascular factors on EOD and LOD risk in an Italian population. Using a case–control study design, EOD and LOD cases were recruited at the Modena Cognitive Neurology Centers in 2016–2019. Controls were recruited among caregivers of all the dementia cases. Information about their demographics, lifestyles, and medical history were collected through a tailored questionnaire. We used the odds ratio (OR) and 95% confidence interval (CI) to estimate the EOD and LOD risk associated with the investigated factors after adjusting for potential confounders. Of the final 146 participants, 58 were diagnosed with EOD, 34 with LOD, and 54 were controls. According to their medical history, atrial fibrillation was associated with increased disease risk (ORs 1.90; 95% CI 0.32–11.28, and 3.64; 95% CI 0.32–41.39 for EOD and LOD, respectively). Dyslipidemia and diabetes showed a positive association with EOD, while the association was negative for LOD. We could not evaluate the association between myocardial infarction and EOD, while increased risk was observed for LOD. No clear association emerged for carotid artery stenosis or valvular heart disease. In this study, despite the limited number of exposed subjects and the high imprecision of the estimates, we found positive associations between cardiovascular disease, particularly dyslipidemia, diabetes, and atrial fibrillation, and EOD.

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“…In another review of published studies on diabetic patients with MCI, their reduced rate of cognitive decline was clearly shown as being due to the treatment of diabetes since the RR in four studies was 0.53 when individuals taking medications were compared with those not taking them [ 16 ]. It is notable that prediabetes, defined as HbA1c 5.7–6.4%, did not predict subsequent dementia for the 11,656 participants of the Atherosclerosis Risk in Communities (ARIC) study [ 17 ]. In that study, an earlier age of onset of diabetes had the strongest association with dementia as follows: for onset before 60 years, HR 2.92; for onset at 60–69 years, HR 1.73; and for onset at 70–79 years, HR 1.23.…”

Section: Diabetes Insulin Resistance and Admentioning

confidence: 99%

Formulating Treatment to Cure Alzheimer’s Dementia: Approach #2

Fessel

2024

IJMS

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There are two generic approaches to curing any medical condition. The first one treats every patient for all the known possible causes that contribute to pathogenesis; the second one individualizes potentially curative therapy by only identifying in each separate patient the components of pathogenesis that are actually operative and treating those. This article adopts the second approach for formulating a cure for Alzheimer’s dementia (AD). The components of AD’s pathogenesis are, in alphabetical order, as follows: circadian rhythm disturbances, depression, diabetes and insulin resistance, dyslipidemia, hypertension, inflammation, metabolic syndrome, mitochondrial dysfunction, nutritional deficiencies, TGF-β deficiency, underweight, vascular abnormalities, and Wnt/β-catenin deficiency. For each component, data are described that show the degree to which its prevalence is higher in patients with mild cognitive impairment (MCI) who did not revert to having normal cognition than in those who did because the former group is the pool of patients in which future AD may develop. Only addressing the components that are present in a particular individual potentially is a curative strategy. Published data indicate that curative therapy requires the number of such components that are addressed to be ≥3. Although structural brain changes cannot be directly addressed, the impaired neural tracts result from many of the reversible causal elements, so correcting them will benefit these tracts.

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Prediabetes, intervening diabetes and subsequent risk of dementia: the Atherosclerosis Risk in Communities (ARIC) study

Cited by 13 publications

References 34 publications

Cardiovascular risk factors among older persons with cognitive frailty in middle income country

Cardiovascular risk factors among older persons with cognitive frailty in middle income country

Atrial Fibrillation and Other Cardiovascular Factors and the Risk of Dementia: An Italian Case–Control Study

Formulating Treatment to Cure Alzheimer’s Dementia: Approach #2

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