Why is learning and memory dysfunction in Type 2 diabetes limited to older adults?

Ryan, Christopher M.; Geckle, Michelle

doi:10.1002/1520-7560(2000)9999:9999<::aid-dmrr141>3.0.co;2-x

Cited by 166 publications

(133 citation statements)

References 97 publications

(83 reference statements)

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“…Many studies confirmed that sustained hyperglycemia, indicated by elevated HbA1c, is an independent risk factor for the cognitive impairment [39]. Other researchers also noticed that ghrelin levels in obesity patients was lower compared to agematched controls health people [40], and they are negatively correlated with BMI [9,41].…”

Section: Discussionsupporting

confidence: 92%

Ghrelin Levels in Elderly, Diabetic Patients with Mild Cognitive Impairment

Górska-Ciebiada¹,

Cypryk²,

Borkowska³

et al. 2018

Neuropsychiatry

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Objective:The etiology of cognitive impairment in diabetes is unknown, but probably associated with many factors. One of the recent hypotheses suggests that ghrelin could be involved in cognitive impairment in diabetic patients. It has been reported that ghrelin signaling occurs in the hippocampus and improves memory and spatial learning. The aim of this study was to evaluate serum levels of ghrelin in elderly, diabetic patients with and without mild cognitive impairment (MCI) and to determine the predictors of having MCI in elderly diabetics. Methods:The cross-sectional study was conduct among 276 elderly subjects with type 2 diabetes. 87 patients with MCI and 189 controls were selected according to the criteria proposed by the MCI Working Group of the European Consortium on Alzheimer's Disease (using the Montreal Cognitive Assessment: MoCA score). Data of biochemical parameters and biomarkers were collected. The serum levels of ghrelin were assessed using ELISA kit. Results:Serum levels of ghrelin were significantly lower in patients with MCI compared to controls. In MCI patients serum ghrelin levels were positively correlated with MoCA score and negatively correlated with HbA1c and BMI. The logistic regression models revealed that variables which increased the likelihood of diagnosis of MCI in elderly diabetic patients were: lower levels of ghrelin, higher levels of HbA1c, hypertension, previous cardiovascular disease, increased number of co-morbidities, and less years of formal education. Conclusion:In summary, serum levels of ghrelin were decreased in MCI elderly diabetic patients compared to controls and associated with poor MoCA score. The results indicated that lower ghrelin levels may be a risk factor for a cognitive impairment in diabetic, elderly patients. Further prospective larger studies are needed to confirm the role of this marker in the progression to dementia.

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Section: Discussionsupporting

confidence: 92%

Ghrelin Levels in Elderly, Diabetic Patients with Mild Cognitive Impairment

Górska-Ciebiada¹,

Cypryk²,

Borkowska³

et al. 2018

Neuropsychiatry

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“…Research on type 2 diabetes suggests that there may be an interaction between age and the severity of cognitive problems: cognitive deficits appear to be more pronounced in individuals who are Ͼ60 -65 years of age (49). Thus far, no studies have addressed the effects of type 1 diabetes on cognition in individuals of more advanced age.…”

Section: Conclusion -mentioning

confidence: 99%

The Effects of Type 1 Diabetes on Cognitive Performance

et al. 2005

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OBJECTIVE -To investigate the exact nature and magnitude of cognitive impairments in patients with type 1 diabetes and the possible association with other disease variables, such as recurrent episodes of hypoglycemia and metabolic control.RESEARCH DESIGN AND METHODS -MedLine and PsycLit search engines were used to identify studies on cognitive performance in patients with type 1 diabetes. Effect sizes (Cohen's d), which are the standardized differences between the experimental and the control group, were calculated. In the meta-analysis, a combined d value was calculated, expressing the magnitude of associations across studies.RESULTS -A total of 33 studies were identified that met the inclusion criteria. Compared with nondiabetic control subjects, the type 1 diabetic group demonstrated a significantly lowered performance on the following cognitive domains: intelligence (d ϭ Ϫ0.7), speed of information processing (d ϭ Ϫ0.3), psychomotor efficiency (d ϭ Ϫ0.6), visual (d ϭ Ϫ0.4) and sustained attention (d ϭ Ϫ0.3), cognitive flexibility (d ϭ Ϫ0.5), and visual perception (d ϭ Ϫ0.4). Lowered cognitive performance in diabetic patients appeared to be associated with the presence of microvascular complications but not with the occurrence of severe hypoglycemic episodes or with poor metabolic control.CONCLUSIONS -In patients with type 1 diabetes, cognitive dysfunction is characterized by a slowing of mental speed and a diminished mental flexibility, whereas learning and memory are spared.The magnitude of the cognitive deficits is mild to moderate, but even mild forms of cognitive dysfunction might hamper everyday activities since they can be expected to present problems in more demanding situations. Diabetes Care 28:726 -735, 2005

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“…This latter group has an increased risk of cognitive impairment [3], which may be associated with insulin therapy [4,5]. Since the association between diabetes and cognitive impairment appears confined to middle-aged or older individuals [6], the ageing brain could be particularly susceptible to neuroglycopenia. The interpretation of studies examining the relationship between blood glucose-lowering therapies, hypoglycaemia and cognitive function in type 2 diabetes is, however, complicated by factors other than age, such as duration of diabetes and of insulin treatment, comorbidities, including renal insufficiency, and polypharmacy [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Severe hypoglycaemia and cognitive impairment in older patients with diabetes: the Fremantle Diabetes Study

et al. 2009

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Aims/hypothesis The aim was to investigate the relationship between severe hypoglycaemia and cognitive impairment in older patients with diabetes. Methods A sample of 302 diabetic patients aged ≥70 years was assessed for dementia or cognitive impairment without dementia in 2001-2002 and a subsample of non-demented patients (n=205) was followed to assess cognitive decline. A history of severe hypoglycaemia was determined from self-reports, physician assessments and records of health service use for hypoglycaemia (HSH). Prospective HSH was determined up to 2006. Data analysis, including multiple logistic and Cox regression models, was used to determine whether: (1) there were cross-sectional associations between hypoglycaemia and cognitive status, (2) historical hypoglycaemia predicted cognitive decline, and (3) baseline cognitive status predicted subsequent HSH.Results There were significant cross-sectional associations between both cognitive impairment and dementia and hypoglycaemia. Independent risk factors for future HSH included dementia (hazard ratio 3.00, 95% CI 1.06-8.48) and inability to self-manage medications (hazard ratio 4.17, 95% CI 1.43-12.13). However, there were no significant associations between historical hypoglycaemia, incident HSH and cognitive decline. Conclusions/interpretation Dementia is an important risk factor for hypoglycaemia requiring health service utilisation. We found no evidence that hypoglycaemia contributes to cognitive impairment in older patients with diabetes.

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Why is learning and memory dysfunction in Type 2 diabetes limited to older adults?

Cited by 166 publications

References 97 publications

Ghrelin Levels in Elderly, Diabetic Patients with Mild Cognitive Impairment

Ghrelin Levels in Elderly, Diabetic Patients with Mild Cognitive Impairment

The Effects of Type 1 Diabetes on Cognitive Performance

Severe hypoglycaemia and cognitive impairment in older patients with diabetes: the Fremantle Diabetes Study

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