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Review
. 2012;30 Suppl 2(0):S185-98.
doi: 10.3233/JAD-2012-111433.

Type 2 diabetes and cognitive impairment: linking mechanisms

José A Luchsinger  1
Affiliations
Review

Type 2 diabetes and cognitive impairment: linking mechanisms

José A Luchsinger. J Alzheimers Dis. 2012.

Abstract

This manuscript provides a brief review of current concepts in the mechanisms potentially linking type-2-diabetes (T2D) with cognitive impairment. Existing epidemiologic studies, imaging studies, autopsy studies, and clinical trials provide insights into the mechanisms linking T2D and cognitive impairment. There seems to be little dispute that T2D can cause cerebrovascular disease and thus cause vascular cognitive impairment (VCI). Whether T2D can cause late onset Alzheimer's disease (LOAD) remains to be elucidated. Many epidemiologic studies show an association between T2D and cognitive impairment, but the association with VCI seems to be stronger compared to LOAD, suggesting that cerebrovascular disease may be the main mechanism linking T2D and cognitive impairment. Imaging studies show an association between T2D and imaging markers of LOAD, but these observations could still be explained by cerebrovascular mechanisms. Autopsy studies are few and conflicting, with some suggesting a predominantly cerebrovascular mechanism, and others providing support for a neurodegenerative mechanism. Thus far, the evidence from clinical trials is mixed in supporting a causal association between T2D and cognitive impairment, and most clinical trials that can answer this question are yet to be reported or finished. Given the epidemic of T2D in the world, it is important to elucidate whether the association between T2D and cognitive impairment, particularly LOAD, is causal, and if so, what the mechanisms are.

Keywords: Type 2 diabetes; dementia; late onset Alzheimer’s disease; mechanisms; vascular cognitive impairment.

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Conflict of interest statement

Conflicts of interest: Dr. Luchsinger has no conflicts of interest to report.

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References

    1. Ritchie K, Lovestone S. The dementias. Lancet. 2002;360:1759–1766. - PubMed
    1. Brookmeyer R, Gray S, Kawas C. Projections of Alzheimer’s disease in the United States and the public health impact of delaying disease onset. Am J Public Health. 1998;88:1337–1342. - PMC - PubMed
    1. Evans DA, Funkenstein HH, Albert MS, Scherr PA, Cook NR, Chown MJ, Hebert LE, Hennekens CH, Taylor JO. Prevalence of Alzheimer’s disease in a community population of older persons. Higher than previously reported. JAMA. 1989;262:2551–2556. - PubMed
    1. Chui HC, Mack W, Jackson JE, Mungas D, Reed BR, Tinklenberg J, Chang FL, Skinner K, Tasaki C, Jagust WJ. Clinical criteria for the diagnosis of vascular dementia: a multicenter study of comparability and interrater reliability. Arch Neurol. 2000;57:191–196. - PubMed
    1. Luis CA, Loewenstein DA, Acevedo A, Barker WW, Duara R. Mild cognitive impairment: directions for future research. Neurology. 2003;61:438–444. - PubMed

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