Risk factors for dementia with type 2 diabetes mellitus among elderly people in China
ABSTRACT OBJECTIVE: to investigate the prevalence and risk factors of diabetes to dementia and its subtypes such as Alzheimer disease (AD) and vascular dementia (VD) among the Chinese elderly population. METHODS: among 8,213 Chinese people aged 65 years and older, 1,109 subjects with type 2 diabetes millitus (T2DM) were ascertained by interview and direct glucose testing. All diabetic subjects were initially screened with the "DSM-IV criteria" for dementia and its subtypes. We compared the prevalence of dementia in diabetic patients with that in ordinary subjects, and analyzed the association of the status of diabetes with dementia including AD and VD. Logistic regression was used to assess OR of dementia and its subtypes with T2DM. RESULTS: after a comprehensive geriatric and cognitive assessment, 132 diabetic subjects were diagnosed with all-cause dementia. The prevalence rate for dementia with T2DM was 1.61%. Of demented subjects, 37 subjects had AD, 30 subjects had VD. The prevalence rates for AD with T2DM and VD with T2DM were 4.51% and 3.65%, respectively. In the univariate analyses, among all diabetic subjects, compared with cognitive intactly subjects, the demented subjects, including AD and VD subjects, were older, more female had higher percentage of current smoking, had a greater duration of diabetes, took more frequent use of diabetes medications, and stronger effect of APOE ε4 status. In multivariate logistic regression analyses, variables including age, APOE ε4 allele, duration from onset of diabetes, using oral hypoglycemic agents, HMG-CoA reductase (statins) were significantly associated with increased risk for dementia with T2DM (all P < 0.05). CONCLUSIONS: the present study shows that T2DM is associated with dementia and its subtypes amongst elderly people in the Chinese population.
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ABSTRACT: Background: Western diets are associated with obesity, vascular diseases, and metabolic syndrome and might increase dementia risk in later life. If these associations are causal, those low- and middle-income countries experiencing major changes in diet might also see an increasing prevalence of dementia. Objective: To investigate the relationship of dietary supply and the prevalence of dementia in mainland China, Hong Kong, and Taiwan over time using existing data and taking diagnostic criteria into account. Methods: Estimated total energy supply and animal fat from the United Nations was linked to the 70 prevalence studies in mainland China, Hong Kong, and Taiwan from 1980 to 2012 according to the current, 10 years, and 20 years before starting year of investigation. Studies using newer and older diagnostic criteria were separated into two groups. Spearman's rank correlation was calculated to investigate whether trends in total energy, animal fat supply, and prevalence of dementia were monotonically related. Results: The supply of total energy and animal fat per capita per day in China increased considerably over the last 50 years. The original positive relationship of dietary supply and dementia prevalence disappeared after stratifying by newer and older diagnostic criteria and there was no clear time lag effect. Conclusion: Taking diagnostic criteria into account, there is no cross-sectional or time lag relationship between the dietary trends and changes in dementia prevalence. It may be too early to detect any such changes because current cohorts of older people did not experience these dietary changes in their early to mid-life.Journal of Alzheimer's disease: JAD 11/2014; DOI:10.3233/JAD-141926 · 3.61 Impact Factor
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ABSTRACT: Type 2 diabetes is associated with cognitive dysfunction and structural brain changes. Abnormalities in glucose regulation are involved in several complications related to type 2 diabetes, but their role in these cerebral complications is unclear. We systematically reviewed studies of the association between glucose regulation (glycaemia, hypoglycaemic events, insulin concentration, insulin resistance, and glucose-lowering treatment) and cognitive function and brain abnormalities on MRI in people with type 2 diabetes. The 86 papers included showed that glycaemia, particularly high HbA1c concentration and glucose variability, are negatively associated with cognitive function in people with type 2 diabetes without dementia. However, the strength of this association is weak, and HbA1c generally accounted for less than 10% of the variance in cognition. Importantly, few studies have measured long-term cerebral outcomes, such as dementia and structural brain changes on MRI, and the effect of glucose-lowering treatment on these outcomes. More randomised controlled trials are needed to establish the effect of glucose-lowering treatment on long-term cognitive function in people with type 2 diabetes.01/2014; 3(1). DOI:10.1016/S2213-8587(14)70148-2
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ABSTRACT: The present study was designed to investigate the efficacy of selective ETA receptor antagonist, ambrisentan on hyperhomocysteinemia-induced experimental vascular dementia. L-methionine was administered for 8 weeks to induce hyperhomocysteinemia and associated vascular dementia in male rats. Ambrisentan was administered to L-methionine-treated effect rats for 4 weeks (starting from 5(th) to 8(th) week of L-methionine treatment). On 52(nd) day onward, the animals were exposed to the Morris water maze (MWM) for testing their learning and memory abilities. Vascular endothelial function, serum nitrite/nitrate levels, brain thiobarbituric acid reactive species (TBARS), brain reduced glutathione (GSH) levels, and brain acetylcholinesterase (AChE) activity were also measured. L-methionine-treated animals showed significant learning and memory impairment, endothelial dysfunction, decrease in/serum nitrite/nitrate and brain GSH levels along with an increase in brain TBARS levels and AChE activity. Ambrisentan significantly improved hyperhomocysteinemia-induced impairment of learning, memory, endothelial dysfunction, and changes in various biochemical parameters. These effects were comparable to that of donepezil serving as positive control. It is concluded that ambrisentan, a selective ETA receptor antagonist may be considered as a potential pharmacological agent for the management of hyperhomocysteinemia-induced vascular dementia.Korean Journal of Physiology and Pharmacology 06/2014; 18(3):201-9. DOI:10.4196/kjpp.2014.18.3.201 · 1.26 Impact Factor