News Topic diabetes

About these topic collections

I’ve been reporting on memory research for over ten years and these topic pages are simply collections of all the news items I have made on a particular topic. They do not pretend to be in any way exhaustive! I cover far too many areas within memory to come anywhere approaching that. What I aim to do is provide breadth, rather than depth. Outside my own area of cognitive psychology, it is difficult to know how much weight to give to any study (I urge you to read my blog post on what constitutes scientific evidence). That (among other reasons) is why my approach in my news reporting is based predominantly on replication and consistency. It's about the aggregate. So here is the aggregate of those reports I have at one point considered of sufficient interest to discuss. If you know of any research you would like to add to the collection, feel free to write about it in a comment (please provide a reference).

Data from a survey of 20,000 people across the UK has found that people who cycle, walk, or take public transport to work had a lower risk of being overweight than those who drove or took a taxi. People who walked to work were 40% less likely to have diabetes than those who drove and 17% less likely to have high blood pressure. Cyclists were around half as likely to have diabetes as drivers.

Analysis of insulin-producing cells has revealed that those with type 2 diabetes have epigenetic changes in approximately 800 genes, with altered gene expression in over 100 genes (many of them relating to insulin production).

Epigenetic changes occur as a result of factors including environment and lifestyle, and are reversible. A number of these changes were also found in place in healthy subjects as a result of age or high BMI, suggesting these changes could contribute to the development of the disease

A review of 19 studies involving over 162,000 people has found that adherence to the Mediterranean diet was associated with a 21% reduced risk of diabetes, with a greater effect (27%) for those at high risk for cardiovascular disease. The association was found in both European and non-European groups.

The research was presented at the American College of Cardiology's 63rd Annual Scientific Session.

A 2-year trial involving 59 patients with type 2 diabetes has found that those on a low-carbohydrate diet showed lower levels of inflammation compared with those on a traditional low-fat diet. Weight loss was similar in both groups.

Preliminary studies have demonstrated that grape skin extract exerts a novel inhibitory activity on hyperglycemia and could be developed to aid in diabetes management.

A meta-analysis of six studies from around the world, involving 75,498 couples, has found that a spouse had a 26% greater risk of developing diabetes if the other had been diagnosed with type 2 diabetes.

DNA data from more than 48,000 patients and 139,000 healthy controls from four different ethnic groups has identified seven new genetic regions associated with type 2 diabetes.

It is now realized that the focus in treating diabetes shouldn’t be so much on controlling blood sugar. New medical guidelines point to the importance of the following interventions (in order of benefit):

  1. smoking cessation (most important)
  2. blood pressure control
  3. metformin drug therapy
  4. lipid reduction
  5. glycemic control (least important).

This isn’t to say that blood sugar isn’t important; but the others should be dealt with first.

A study involving 614 patients with type 2 diabetes (mean age 62) has found that longer duration of diabetes was associated with more brain volume loss, particularly in the gray matter. Roughly, for every 10 years of diabetes, the brain was similar to that of a non-diabetic person who was two years older.

However, the study did not confirm any association of diabetes characteristics with small vessel ischemic disease.


Type 2 diabetes greatly increases a person's risk of developing cardiovascular disease, but a new study shows that cardiovascular risk factors such as elevated blood pressure and cholesterol levels differ significantly between men and women with diabetes.

The study, involving 680 diabetics, found that blood pressure and LDL cholesterol levels were significantly higher in women, and women were significantly less likely to have these factors under control. Some 17% of men had control of these factors, compared to 6% of women.

The findings suggest that more effort should be put into informing women about cardiovascular risk factors and how to reduce them.

Journal article freely available at


Preliminary results for a small study indicate metabolic syndrome is linked to significantly reduced blood flow in the brain, perhaps explaining its link to cognitive impairment.

I’ve reported before on the growing evidence that metabolic syndrome in middle and old age is linked to greater risk of cognitive impairment in old age and faster decline. A new study shows at least part of the reason.

The study involved 71 middle-aged people recruited from the Wisconsin Registry for Alzheimer's Prevention (WRAP), of whom 29 met the criteria for metabolic syndrome (multiple cardiovascular and diabetes risk factors including abdominal obesity, high blood pressure, high blood sugar and high cholesterol).

Those with metabolic syndrome averaged 15% less blood flow to the brain than those without the syndrome.

One tried and true method of increasing blood flow to the brain is of course through exercise.

The study was presented at the Alzheimer's Association International Conference in Vancouver, Canada by Barbara Bendlin.

A large, long-running study has found cognitive decline and brain lesions are linked to mild retinal damage in older women.

Damage to the retina (retinopathy) doesn’t produce noticeable symptoms in the early stages, but a new study indicates it may be a symptom of more widespread damage. In the ten-year study, involving 511 older women (average age 69), 7.6% (39) were found to have retinopathy. These women tended to have lower cognitive performance, and brain scans revealed that they had more areas of small vascular damage within the brain — 47% more overall, and 68% more in the parietal lobe specifically. They also had more white matter damage. They did not have any more brain atrophy.

These correlations remained after high blood pressure and diabetes (the two major risk factors for retinopathy) were taken into account. It’s estimated that 40-45% of those with diabetes have retinopathy.

Those with retinopathy performed similarly to those without on a visual acuity test. However, testing for retinopathy is a simple test that should routinely be carried out by an optometrist in older adults, or those with diabetes or hypertension.

The findings suggest that eye screening could identify developing vascular damage in the brain, enabling lifestyle or drug interventions to begin earlier, when they could do most good. The findings also add to the reasons why you shouldn’t ignore pre-hypertensive and pre-diabetic conditions.

Two recent studies add to evidence that sleeping poorly is a risk factor for several disorders in old age, including mild cognitive impairment, Parkinson’s, cardiovascular disease and diabetes.

Older adults who sleep poorly react to stress with increased inflammation

A study involving 83 older adults (average age 61) has found that poor sleepers reacted to a stressful situation with a significantly greater inflammatory response than good sleepers. High levels of inflammation increase the risk of several disorders, including cardiovascular disease and diabetes, and have been implicated in Alzheimer’s.

Each participant completed a self-report of sleep quality, perceived stress, loneliness and medication use. Around 27% were categorized as poor sleepers. Participants were given a series of tests of verbal and working memory designed to increase stress, with blood being taken before and after testing, as well as three more times over the next hour. The blood was tested for levels of a protein marker for inflammation (interleukin-6).

Poor sleepers reported more depressive symptoms, more loneliness and more perceived stress compared to good sleepers. Before cognitive testing, levels of IL-6 were the same for poor and good sleepers. However, while both groups showed increases in IL-6 after testing, poor sleepers showed a significantly larger increase — as much as four times larger and at a level found to increase risk for illness and death in older adults.

After accounting for loneliness, depression or perceived stress, this association remained. Surprisingly, there was no evidence that poor sleep led to worse cognitive performance, thus causing more stress. Poor sleepers did just as well on the tests as the good sleepers (although I note that we cannot rule out that poor sleepers were having to put in more effort to achieve the same results). Although there was a tendency for poor sleepers to be in a worse mood after testing (perhaps because they had to put in more effort? My own speculation), this mood change didn’t predict the increased inflammatory response.

The findings add to evidence that poor sleep (unfortunately common as people age) is an independent risk factor for cognitive and physical health, and suggest we should put more effort into dealing with it, rather than just accepting it as a corollary of age.

REM sleep disorder doubles risk of MCI, Parkinson's

A recent Mayo Clinic study has also found that people with rapid eye movement sleep behavior disorder (RBD) have twice the risk of developing mild cognitive impairment or Parkinson’s disease. Some 34% of those diagnosed with probable RBD developed MCI or Parkinson's disease within four years of entering the study, a rate 2.2 times greater than those with normal REM sleep.

Earlier research has found that 45% of those with RBD developed MCI or Parkinson's disease within five years of diagnosis, but these findings were based on clinical patients. The present study involved cognitively healthy older adults (70-89) participating in a population-based study of aging, who were diagnosed for probable RBD on the basis of the Mayo Sleep Questionnaire.

HIV-related cognitive impairment is significantly associated with a greater waist circumference, and in older adults, with diabetes.

A study involving 130 HIV-positive people has found that memory impairment was associated with a significantly larger waistline.

Some 40% of participants (average age 46) had impaired cognition. This group had an average waist circumference of 39 inches, compared to 35 inches for those without such problems. Memory impairment was also linked to diabetes in those older than 55 (15% of those with memory problems had diabetes compared to only 3% of those without memory problems).

Waistline was more important than BMI. Unfortunately, some anti-HIV drugs cause weight gain in this area.

The finding is consistent with evidence that abdominal weight is more important than overall weight for cognitive impairment and dementia in the general population.

For more about HIV-related cognitive impairment

The link between diabetes and cognitive impairment in older adults seems to be mediated by the release of molecules that increase inflammation, leading to constricted blood vessels, thus reduced blood flow, and finally loss of gray matter.

Why is diabetes associated with cognitive impairment and even dementia in older adults? New research pinpoints two molecules that trigger a cascade of events that end in poor blood flow and brain atrophy.

The study involved 147 older adults (average age 65), of whom 71 had type 2 diabetes and had been taking medication to manage it for at least five years. Brain scans showed that the diabetic patients had greater blood vessel constriction than the age- and sex-matched controls, and more brain atrophy. The reduction in brain tissue was most marked in the grey matter in the parietal and occipital lobes and cerebellum. Research has found that, at this age, while the average brain shrinks by about 1% annually, a diabetic brain might shrink by as much as 15%. Diabetics also had more white matter hyperintensities in the temporal, parietal and occipital lobes.

Behaviorally, the diabetics also had greater depression, slower walking, and executive dysfunction.

The reduced performance of blood vessels (greater vasoconstriction, blunted vasodilatation), and increased brain atrophy in the frontal, temporal, and parietal lobes, was associated with two adhesion molecules – sVCAM and sICAM. White matter hyperintensities were not associated with the adhesion molecules, inflammatory markers, or blood vessel changes.

It seems that the release of these molecules, probably brought about by chronic hyperglycemia and insulin resistance, produces chronic inflammation, which in turn brings about constricted blood vessels, reduced blood flow, and finally loss of neurons. The blood vessel constriction and the brain atrophy were also linked to higher glucose levels.

The findings suggest that these adhesion molecules provide two biomarkers of vascular health that could enable clinicians to recognize impending brain damage, that could then perhaps be prevented.

The findings also add weight to the growing evidence that diabetes management is crucial in preventing cognitive decline.

New research confirms the correlation between lower neighborhood socioeconomic status and lower cognitive function in older adults, and accounts for most of it through vascular health, lifestyle, and psychosocial factors.

In the last five years, three studies have linked lower neighborhood socioeconomic status to lower cognitive function in older adults. Neighborhood has also been linked to self-rated health, cardiovascular disease, and mortality. Such links between health and neighborhood may come about through exposure to pollutants or other environmental stressors, access to alcohol and cigarettes, barriers to physical activity, reduced social support, and reduced access to good health and social services.

Data from the large Women’s Health Initiative Memory Study has now been analyzed to assess whether the relationship between neighborhood socioeconomic status can be explained by various risk and protective factors for poor cognitive function.

Results confirmed that higher neighborhood socioeconomic status was associated with higher cognitive function, even after individual factors such as age, ethnicity, income, education, and marital status have been taken into account. A good deal of this was explained by vascular factors (coronary heart disease, diabetes, stroke, hypertension), health behaviors (amount of alcohol consumed, smoking, physical activity), and psychosocial factors (depression, social support). Nevertheless, the association was still (barely) significant after these factors were taken account of, suggesting some other factors may also be involved. Potential factors include cognitive activity, diet, and access to health services.

In contradiction of earlier research, the association appeared to be stronger among younger women. Consistent with other research, the association was stronger for non-White women.

Data from 7,479 older women (65-81) was included in the analysis. Cognitive function was assessed by the Modified MMSE (3MSE). Neighborhood socioeconomic status was assessed on the basis of: percentage of adults over 25 with less than a high school education, percentage of male unemployment, percentage of households below the poverty line, percentage of households receiving public assistance, percentage of female-headed households with children, and median household income. Around 87% of participants were White, 7% Black, 3% Hispanic, and 3% other. Some 92% had graduated high school, and around 70% had at least some college.

[2523] Shih, R. A., Ghosh-Dastidar B., Margolis K. L., Slaughter M. E., Jewell A., Bird C. E., et al. (2011).  Neighborhood Socioeconomic Status and Cognitive Function in Women. Am J Public Health. 101(9), 1721 - 1728.


Lang IA, Llewellyn DJ, Langa KM, Wallace RB, Huppert FA, Melzer D. 2008. Neighborhood deprivation, individual socioeconomic status, and cognitive function in older people: analyses from the English Longitudinal Study of Ageing. J Am Geriatr Soc., 56(2), 191-198.

Sheffield KM, Peek MK. 2009. Neighborhood context and cognitive decline in older Mexican Americans: results from the Hispanic Established Populations for Epidemiologic Studies of the Elderly. Am J Epidemiol., 169(9), 1092-1101.

Wight RG, Aneshensel CS, Miller-Martinez D, et al. 2006. Urban neighborhood context, educational attainment, and cognitive function among older adults. Am J Epidemiol., 163(12), 1071-1078.

A study of Michigan public schools, and a mouse study, add to growing evidence that high levels of air pollution negatively affect learning and memory.

Following several recent studies pointing to the negative effect of air pollution on children’s cognitive performance (see this April 2010 news report and this May 2011 report), a study of public schools in Michigan has found that 62.5% of the 3660 schools in the state are located in areas with high levels of industrial pollution, and those in areas with the highest industrial air pollution levels had the lowest attendance rates and the highest proportions of students who failed to meet state educational testing standards in English and math. Attendance rates are a potential indicator of health levels.

Minority students were especially hit by this — 81.5% of African American and 62.1% of Hispanic students attend schools in the top 10% of the most polluted areas, compared to 44.4% of white students.

Almost all (95%) of the industrial air pollution around schools comes from 12 chemicals (diisocyanates, manganese, sulfuric acid, nickel, chlorine, chromium, trimethylbenzene, hydrochloric acid, molybdenum trioxide, lead, cobalt and glycol ethers) that are all implicated in negative health effects, including increased risk of respiratory, cardiovascular, developmental and neurological disorders, as well as cancer.

There are potentially two issues here: the first is that air pollution causes health issues which lower school attendance and thus impacts academic performance; the other is that the pollution also directly effects the brain, thus affecting cognitive performance.

A new mouse study looking at the effects of air pollution on learning and memory has now found that male mice exposed to polluted air for six hours a day, five days a week for 10 months (nearly half their lifespan), performed significantly more poorly on learning and memory tasks than those male mice living in filtered air. They also showed more signs of anxiety- and depressive-like behaviors.

These changes in behavior and cognition were linked to clear differences in the hippocampus — those exposed to polluted air had fewer dendritic spines in parts of the hippocampus (CA1 and CA3 regions), shorter dendrites and overall reduced cell complexity. Previous mouse research has also found that such pollution causes widespread inflammation in the body, and can be linked to high blood pressure, diabetes and obesity. In the present study, the same low-grade inflammation was found in the hippocampus. The hippocampus is particularly sensitive to damage caused by inflammation.

The level of pollution the mice were exposed to was equivalent to what people may be exposed to in some polluted urban areas.

Consistent with evidence linking obesity and impaired cognition, a new study has found improved cognition in obese patients after bariatric surgery.

Growing evidence links obesity and poorer cognitive performance. Many factors associated with obesity, such as high blood pressure, type 2 diabetes and sleep apnea, damage the brain.

A study involving109 bariatric surgery patients and 41 obese control subjects has found that the bariatric surgery patients demonstrated improved memory and concentration 12 weeks after surgery, improving from the slightly impaired range to the normal range. That of the obese controls actually declined over this period. The improvement of those who had surgery seemed to be particularly related to improved blood pressure.

Study participants will be tested one year and two years after surgery.

[2224] Gunstad, J., Strain G., Devlin M. J., Wing R., Cohen R. A., Paul R. H., et al. (2010).  Improved memory function 12 weeks after bariatric surgery. Surgery for Obesity and Related Diseases.

New findings reveal that mild cognitive impairment is more likely to develop into Alzheimer’s if vascular risk factors are present, especially if untreated.

A study following 837 people with MCI, of whom 414 (49.5%) had at least one vascular risk factor, has found that those with risk factors such as high blood pressure, diabetes, cerebrovascular disease and high cholesterol were twice as likely to develop Alzheimer's disease. Over five years, 52% of those with risk factors developed Alzheimer's, compared to 36% of those with no risk factors In total, 298 people (35.6%) developed Alzheimer's.

However, of those with vascular risk factors, those receiving full treatment for their vascular problems were 39% less likely to develop Alzheimer's disease than those receiving no treatment, and those receiving some treatments were 26% less likely to develop the disease.

Treatment of risk factors included using high blood pressure medicines, insulin, cholesterol-lowering drugs and diet control. Smoking and drinking were considered treated if the person stopped smoking or drinking at the start of the study.

Three more studies point to the increased risk of memory loss in older adults with cardiovascular problems.

The new label of ‘metabolic syndrome’ applies to those having three or more of the following risk factors: high blood pressure, excess belly fat, higher than normal triglycerides, high blood sugar and low high-density lipoprotein (HDL) cholesterol (the "good" cholesterol). Metabolic syndrome has been linked to increased risk of heart attack.

A new French study, involving over 7,000 older adults (65+) has found that those with metabolic syndrome were 20% more likely to show cognitive decline on a memory test (MMSE) over a two or four year interval. They were also 13% more likely to show cognitive decline on a visual working memory test. Specifically, higher triglycerides and low HDL cholesterol were linked to poorer memory scores; diabetes (but not higher fasting blood sugar) was linked to poorer visual working memory and word fluency scores.

The findings point to the importance of managing the symptoms of metabolic syndrome.

High cholesterol and blood pressure in middle age tied to early memory problems

Another study, involving some 4800 middle-aged adults (average age 55), has found that those with higher cardiovascular risk were more likely to have lower cognitive function and a faster rate of cognitive decline over a 10-year period. A 10% higher cardiovascular risk was associated not only with increased rate of overall mental decline, but also poorer cognitive test scores in all areas except reasoning for men and fluency for women.

The cardiovascular risk score is based on age, sex, HDL cholesterol, total cholesterol, systolic blood pressure and whether participants smoked or had diabetes.

Memory problems may be sign of stroke risk

A very large study (part of the REGARDS study) tested people age 45 and older (average age 67) who had never had a stroke. Some 14,842 people took a verbal fluency test, and 17,851 people took a word recall memory test. In the next 4.5 years, 123 participants who had taken the verbal fluency test and 129 participants who had taken the memory test experienced a stroke.

Those who had scored in the bottom 20% for verbal fluency were 3.6 times more likely to develop a stroke than those who scored in the top 20%. For the memory test, those who scored in the bottom 20% were 3.5 times more likely to have a stroke than those in the top quintile.

The effect was greatest at the younger ages. At age 50, those who scored in the bottom quintile of the memory test were 9.4 times more likely to later have a stroke than those in the top quintile.


Together, these studies, which are consistent with many previous studies, confirm that cardiovascular problems and diabetes add to the risk of greater cognitive decline (and possible dementia) in old age. And point to the importance of treating these problems as soon as they appear.

[2147] Raffaitin, C., Féart C., Le Goff M., Amieva H., Helmer C., Akbaraly T. N., et al. (2011).  Metabolic syndrome and cognitive decline in French elders. Neurology. 76(6), 518 - 525.

The findings of the second and third studies are to be presented at the American Academy of Neurology's 63rd Annual Meeting in Honolulu April 9 to April 16, 2011

Older adults who have a history of severe headaches are more likely to have a greater number of brain lesions, but do not show greater cognitive impairment (within the study time-frame).

Lesions of the brain microvessels include white-matter hyperintensities and the much less common silent infarcts leading to loss of white-matter tissue. White-matter hyperintensities are common in the elderly, and are generally regarded as ‘normal’ (although a recent study suggested we should be less blasé about them — that ‘normal’ age-related cognitive decline reflects the presence of these small lesions). However, the degree of white-matter lesions is related to the severity of decline (including increasing the risk of Alzheimer’s), and those with hypertension or diabetes are more likely to have a high number of them.

A new study has investigated the theory that migraines might also lead to a higher number of white-matter hyperintensities. The ten-year French population study involved 780 older adults (65+; mean age 69). A fifth of the participants (21%) reported a history of severe headaches, of which 71% had migraines.

Those with severe headaches were twice as likely to have a high quantity of white-matter hyperintensities as those without headaches. However, there was no difference in cognitive performance between the groups. Those who suffered from migraines with aura (2% of the total), also showed an increased number of silent cerebral infarcts — a finding consistent with other research showing that people suffering from migraine with aura have an increased risk of cerebral infarction (or strokes). But again, no cognitive decline was observed.

The researchers make much of their failure to find cognitive impairment, but I would note that, nevertheless, the increased number of brain lesions does suggest that, further down the track, there is likely to be an effect on cognitive performance. Still, headache sufferers can take comfort in the findings, which indicate the effect is not so great that it shows up in this decade-long study.

A new study suggests that the link between midlife obesity and cognitive impairment and dementia in old age may be explained by poorer insulin sensitivity.

Previous research has indicated that obesity in middle-age is linked to higher risk of cognitive decline and dementia in old age. Now a study of 32 middle-aged adults (40-60) has revealed that although obese, overweight and normal-weight participants all performed equally well on a difficult cognitive task (a working memory task called the 2-Back task), obese individuals displayed significantly lower activation in the right inferior parietal cortex. They also had lower insulin sensitivity than their normal weight and overweight peers (poor insulin sensitivity may ultimately lead to diabetes). Analysis pointed to the impaired insulin sensitivity mediating the relationship between task-related activation in that region and BMI.

This suggests that it is insulin sensitivity that is responsible for the higher risk of cognitive impairment later in life. The good news is that insulin sensitivity is able to be modified through exercise and diet.

A follow-up study to determine if a 12-week exercise intervention can reverse the differences is planned.

Cognitive deficits and even dementia are more common in older diabetics. A new study points to three health issues that, if present, increase the risk that older diabetics will develop cognitive problems.

Type 2 diabetes is known to increase the risk of cognitive impairment in old age. Now analysis of data from 41 older diabetics (aged 55-81) and 458 matched controls in the Victoria Longitudinal Study has revealed that several other factors make it more likely that an older diabetic will develop cognitive impairment. These factors are: having higher (though still normal) blood pressure, having gait and balance problems, and/or reporting yourself to be in bad health regardless of actual problems.

Diabetes and hypertension often go together, and both are separately associated with greater cognitive impairment and dementia risk, so it is not surprising that higher blood pressure is one of the significant factors that increases risk. The other factors are less expected, although gait and balance problems have been linked to cognitive impairment in a recent study, and they may be connected to diabetes through diabetes’ effect on nerves. Negativity about one’s health may reflect emotional factors such as anxiety, stress, or depression, although depression and well-being measures were not themselves found to be mediating effects for cognitive impairment in diabetics (Do note that this study is not investigating which factors, in general, are associated with age-related cognitive impairment; it is trying to establish which factors are specifically sensitive to cognitive impairment in older diabetics).

In the U.S., type 2 diabetes occurs in over 23% of those over 60; in Canada (where this study took place) the rate is 19%. It should be noted that the participants in this study are not representative of the general population, in that they were fairly well-educated older Canadians, most of whom have benefited from a national health care system. Moreover, the study did not have longitudinal data on these various factors, meaning that we don’t know the order of events (which health problems come first? How long between the development of the different problems?). Nevertheless, the findings provide useful markers to alert diabetics and health providers.

Another study adds to growing evidence that diabetes, or poor glycaemic control, has serious implications for brain function.

A small study comparing 18 obese adolescents with type 2 diabetes and equally obese adolescents without diabetes or pre-diabetes has found that those with diabetes had significantly impaired cognitive performance, as well as clear abnormalities in the integrity of their white matter (specifically, reduced white matter volume, especially in the frontal lobe, as well as impaired integrity in both white and grey matter). Similar abnormalities have previously been found in adults with type 2 diabetes, but the subjects were elderly and, after many years of diabetes, generally had significant vascular disease. One study involving middle-aged diabetics found a reduction in the volume of the hippocampus, which was directly associated with poor glycaemic control.

It remains to be seen whether such changes can be reversed by exercise and diet interventions. While those with diabetes performed worse in all cognitive tasks tested, the differences were only significant for intellectual functioning, verbal memory and psychomotor efficiency.

New evidence suggests that Down syndrome, Alzheimer's, diabetes, and cardiovascular disease, all share a common disease mechanism.

It’s been suggested before that Down syndrome and Alzheimer's are connected. Similarly, there has been evidence for connections between diabetes and Alzheimer’s, and cardiovascular disease and Alzheimer’s. Now new evidence shows that all of these share a common disease mechanism. According to animal and cell-culture studies, it seems all Alzheimer's disease patients harbor some cells with three copies of chromosome 21, known as trisomy 21, instead of the usual two. Trisomy 21 is characteristic of all the cells in people with Down syndrome. By age 30 to 40, all people with Down syndrome develop the same brain pathology seen in Alzheimer's. It now appears that amyloid protein is interfering with the microtubule transport system inside cells, essentially creating holes in the roads that move everything, including chromosomes, around inside the cells. Incorrect transportation of chromosomes when cells divide produces new cells with the wrong number of chromosomes and an abnormal assortment of genes. The beta amyloid gene is on chromosome 21; thus, having three copies produces extra beta amyloid. The damage to the microtubule network also interferes with the receptor needed to pull low-density lipoprotein (LDL — the ‘bad’ cholesterol) out of circulation, thus (probably) allowing bad cholesterol to build up (note that the ‘Alzheimer’s gene’ governs the low-density lipoprotein receptor). It is also likely that insulin receptors are unable to function properly, leading to diabetes.

A large study of older adults with type-2 diabetes has found those with higher levels of the stress hormone cortisol are more likely to have experienced cognitive decline.

A study involving over 1000 older men and women (60-75) with type-2 diabetes has found that those with higher levels of the stress hormone cortisol in their blood are more likely to have experienced cognitive decline. Higher fasting cortisol levels were associated with greater estimated cognitive decline in general intelligence, working memory and processing speed. This was independent of mood, education, metabolic variables and cardiovascular disease. Strategies aimed at lowering stress levels may be helpful for older diabetics.

Both diabetes and clinical depression are known to be risk factors for dementia. Now a study that tracked nearly 4000 diabetics over 5 years has found having both increased the risk 2.7-fold.

Both diabetes and clinical depression are known to be risk factors for dementia. Now a study that tracked nearly 4000 diabetics over 5 years has found having both increased the risk 2.7-fold. Nearly 8% of the diabetics with major depression (36 of 455) developed dementia over the five years, compared to 4.8% of those with diabetes alone (163 of 3382). Those who developed dementia within 2 years of being diagnosed with depression were excluded. Depression is common among people who have diabetes.

Although roundworm research suggesting different effects at different ages is concerned with genetic manipulation, we may speculate that restricting your food intake is a bad idea for young adults but good for the old, while reducing sugar may be better for the young than it is for the old.

Studies on the roundworm C. elegans have revealed that the molecules required for learning and memory are the same from C. elegans to mammals, suggesting that the basic mechanisms underlying learning and memory are ancient, and that this animal can serve as a testing ground for treatments for age-related memory loss. Intriguingly, a comparison of two known regulators of longevity — reducing calorie intake and reducing activity in the insulin-signaling pathway (achieved through genetic manipulation) — has found that these two treatments produce very different effects on memory. While dietary restriction impaired memory in early adulthood, it maintained memory with age. On the other hand, reduced insulin signaling improved early adult memory performance but failed to preserve it with age. These different effects appear to be linked to expression of CREB, a protein known to be important for long-term memory. Young roundworms with defective insulin receptors had higher levels of CREB protein, while those worms genetically altered to eat less had low levels, but the level did not diminish with age. These findings add to our understanding of why memory declines with age.

Older news items (pre-2010) brought over from the old website

Diabetic episodes affect memory

A study involving 62 children with type 1 diabetes, of whom 33 had experienced diabetic ketoacidosis, has found those with such experience performed significantly worse on a memory test that tested their ability to recall events in association with specific details. The finding points to the importance of avoiding diabetic ketoacidosis, which is avoidable in those known to have diabetes.

[1384] Ghetti, S., Lee J. K., Sims C. E., DeMaster D. M., & Glaser N. S. (2010).  Diabetic Ketoacidosis and Memory Dysfunction in Children with Type 1 Diabetes. The Journal of Pediatrics. 156(1), 109 - 114.

Poor glucose control linked to cognitive impairment in diabetics

The ongoing Memory in Diabetes (MIND) study, involving some 3,000 type 2 diabetics 55 years and older, has found that cognitive functioning abilities drop as average blood sugar levels rise. However, there was no connection between daily blood glucose levels and cognitive performance. The study adds to growing evidence that poorer blood glucose control is strongly associated with poorer memory function, that may eventually lead to mild cognitive impairment, vascular dementia and Alzheimer's disease. It is also possible that people with impaired cognitive ability are less compliant in taking medications and controlling their diabetes. Further research will test the hypothesis that improving glucose control results in improved cognitive function.

[797] Marcovina, S. M., Launer L. J., Cukierman-Yaffe T., Gerstein H. C., Williamson J. D., Lazar R. M., et al. (2009).  Relationship Between Baseline Glycemic Control and Cognitive Function in Individuals With Type 2 Diabetes and Other Cardiovascular Risk Factors. Diabetes Care. 32(2), 221 - 226.

Adult-onset diabetes slows mental functioning in several ways, with deficits appearing early

A comparison of 41 adults with diabetes and 424 adults in good health, aged between 53 and 90, has revealed that healthy adults performed significantly better than adults with diabetes on two of the five domains tested: executive functioning and speed of processing. There were no significant differences on tests of episodic and semantic memory, verbal fluency, reaction time and perceptual speed. The effect remained even when only the younger group (those below 70) were analyzed, indicating that the diabetes-linked cognitive deficits appear early and remain stable.

[796] Yeung, S. E., Fischer A. L., & Dixon R. A. (2009).  Exploring effects of type 2 diabetes on cognitive functioning in older adults. Neuropsychology. 23(1), 1 - 9.


Blood sugar linked to normal cognitive aging

Following research showing that decreasing brain function in the area of the hippocampus called the dentate gyrus is a main contributor of normal age-related cognitive decline, an imaging study has been investigating the cause of this decreasing function by looking at measures that typically change during aging, like rising blood sugar, body mass index, cholesterol and insulin levels. The study of 240 community-based nondemented elders (average age 80 years), of whom 60 had type 2 diabetes, found that decreasing activity in the dentate gyrus only correlated with levels of blood glucose. The same association was also found in aging rhesus monkeys and in mice. The finding suggests that maintaining blood sugar levels, even in the absence of diabetes, could help maintain aspects of cognitive health. It also suggests that one reason why physical exercise benefits memory may be its effect on lowering glucose levels.

[830] Mayeux, R., Vannucci S. J., Small S. A., Wu W., Brickman A. M., Luchsinger J., et al. (2008).  The brain in the age of old: The hippocampal formation is targeted differentially by diseases of late life. Annals of Neurology. 64(6), 698 - 706.

Diabetic seniors may experience memory declines after eating high-fat food

Growing evidence links diabetes to cognitive impairment. Now a small study of 16 adults (aged 50 years and older) with type 2 diabetes compared their cognitive performance on three separate occasions, fifteen minutes after consuming different meals. One meal consisted of high fat products – a danish pastry, cheddar cheese and yogurt with added whipped cream; the second meal was only water; and the third was the high-fat meal plus high doses of vitamins C (1000 mg) and E (800 IU) tablets. Researchers found that vitamin supplementation consistently improved recall scores relative to the meal alone, while those who ate the high fat meal without vitamin supplements showed significantly more forgetfulness of words and paragraph information in immediate and time delay recall tests. Those on water meal and meal with vitamins showed similar levels in cognitive performance. The finding indicates not only that diabetics can temporarily further worsen already underlying memory problems associated with the disease by consuming unhealthy meals, but also that this can be remedied by taking high doses of antioxidant vitamins C and E with the meal, suggesting that the effect of high-fat foods is to cause oxidative stress. However, this is hardly a recommended course of action, and the real importance of this finding is that it emphasizes the need for diabetics to consume healthy foods high in antioxidants, like fruits and vegetables. Of course, this is a very small study, and further replication is needed.

[1094] Chui, M., & Greenwood C. (2008).  Antioxidant vitamins reduce acute meal-induced memory deficits in adults with type 2 diabetes. Nutrition Research. 28(7), 423 - 429.

Stress hormone impacts memory, learning in diabetic rodents

A rodent study sheds light on why diabetes can impair cognitive function. The study found that increased levels of a stress hormone (called cortisol in humans) in diabetic rats impaired synaptic plasticity and reduced neurogenesis in the hippocampus. When levels returned to normal, the hippocampus recovered. Cortisol production is controlled by the hypothalamic-pituitary axis (HPA). People with poorly controlled diabetes often have an overactive HPA axis and excessive cortisol.

[1050] Stranahan, A. M., Arumugam T. V., Cutler R. G., Lee K., Egan J. M., & Mattson M. P. (2008).  Diabetes impairs hippocampal function through glucocorticoid-mediated effects on new and mature neurons. Nature Neuroscience. 11(3), 309 - 317.

Support for view of Alzheimer's as form of diabetes

Research in the last few years has raised the possibility that Alzheimer’s memory loss could be due to a third form of diabetes. A new study clarifies the connection between insulin and Alzheimer’s. It seems that the toxic protein ADDL, found in the brains of individuals with Alzheimer’s, removes insulin receptors from nerve cells, rendering those neurons insulin resistant. The findings suggest that some existing drugs now used to treat diabetic patients may be useful for Alzheimer’s treatment.

Zhao,W-Q. et al. 2007. Amyloid beta oligomers induce impairment of neuronal insulin receptors. FASEB Journal, published online ahead of print August 24.

Tight diabetes control does not impact cognitive ability in type 1 diabetes

A long-running study involving 1,441 type 1 diabetics, aged 13 to 39, has demonstrated that multiple episodes of severe hypoglycaemia, though they can cause confusion, irrational behavior, convulsions and unconsciousness, do not lead to long-term loss of cognitive ability.

[1120] The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications(DCCT/EDIC) Study Research (2007).  Long-Term Effect of Diabetes and Its Treatment on Cognitive Function. N Engl J Med. 356(18), 1842 - 1852.

Brain function not impaired by tight diabetes control and hypoglycemia

Previous research had indicated that tight blood glucose control -- achieved by taking three or more insulin injections daily – meant type 1 diabetics were three times as likely to suffer episodes of severe hypoglycemia, raising the fear that it might lead to a long-term loss of cognitive ability. Now a follow-up study provides the reassuring news that there was no link between multiple severe hypoglycemic reactions and impaired cognitive function in people with type 1 diabetes.

Jacobson, A.M. et al. 2006. Effects of Intensive and Conventional Treatment on Cognitive Function Twelve Years after the Completion of the Diabetes Control and Complications Trial (DCCT). Abstract Number 750232, presented at the American Diabetes Association's 66th Annual Scientific Sessions held in Washington, D.C, June 9—13.

Fat hormone linked to learning and memory

A new study reveals why obese patients who have diabetes also may have problems with their long-term memory. Leptin — the so-called ‘fat’ hormone — doesn't cross into the brain to help regulate appetite in obese people. Leptin also acts in the hippocampus, suggesting that leptin plays a role in learning and memory. The new study supports this by demonstrating that mice navigated a maze better after they received leptin. Moreover, mice with elevated levels of amyloid-beta plaques (characteristic of Alzheimer's) were particularly sensitive to leptin.

[2400] Farr, S. A., Banks W. A., & Morley J. E. (2006).  Effects of leptin on memory processing. Peptides. 27(6), 1420 - 1425.

Diabetics at significantly higher risk for Alzheimer's disease

New findings from the Religious Orders Study add to research suggesting a link between diabetes mellitus and an increased risk of developing Alzheimer's disease. Some aspects of cognitive function appear to be affected differently than others, in particular perceptual speed declined significantly faster in those with diabetes.

[1296] Arvanitakis, Z., Wilson R. S., Bienias J. L., Evans D. A., & Bennett D. A. (2004).  Diabetes Mellitus and Risk of Alzheimer Disease and Decline in Cognitive Function. Arch Neurol. 61(5), 661 - 666.

Risk for lowered cognitive performance greater in people at high risk for stroke

A new large-scale study supports earlier suggestions that those with a high risk for stroke within 10 years are also at risk for lowered cognitive function and show a pattern of deficits similar to that seen in mild vascular cognitive impairment. It is speculated that the reason may lie in structural and functional changes in the brain that do not rise to the level of clinical detection, and this is supported by a recent brain imaging study showing that abnormal brain atrophy is related both to higher risk of stroke and poorer cognitive ability. The probability of experiencing stroke within 10 years was calculated using weighted combinations of age, systolic blood-pressure, presence of diabetes, cigarette smoking, history of cardiovascular disease, treatment for hypertension and atrial fibrillation.

[1422] Elias, M. F., Sullivan L. M., D'Agostino R. B., Elias P. K., Beiser A., Au R., et al. (2004).  Framingham stroke risk profile and lowered cognitive performance. Stroke; a Journal of Cerebral Circulation. 35(2), 404 - 409.


Insulin-degrading enzyme may affect risk of Alzheimer’s disease

A new mouse study suggests that low levels of insulysin, an enzyme that degrades insulin, could increase the risk for Alzheimer's, and points to a new mechanism linking diseases like diabetes and Alzheimer's — the competition of multiple substrates, such as insulin and amyloid-beta, for a limiting amount of the insulysin enzyme. The insulysin enzyme, it seems, also degrades amyloid-beta peptides, and even a partial decrease in insulysin activity was found to raise amyloid-beta peptide levels in the brain.

Miller, B.C., Eckman, E.A., Sambamurti, K., Dobbs, N., Chow, K.M., Eckman, C.B., Hersh, L.B. & Thiele, D.L. 2003. Amyloid-β peptide levels in brain are inversely correlated with insulysin activity levels in vivo. PNAS, 100, 6221-6226. published online before print

Poorly controlled diabetes could lead to dementia in the elderly

It now appears that the reason why diabetic people age 60 and older tend to perform more poorly on cognitive tests is because of improper management of their disease. A recent study evaluated the association between diabetes mellitus status and cognitive function in 2,583 adults aged 60 and older, grouping participants according to their diabetic status (poorly controlled diabetes; adequately controlled diabetes; those with impaired glucose tolerance; and a non-diabetic control group). Cognitive ability was measured by a series of simple memory questions. Only those with poorly controlled diabetes performed poorly on the cognitive test.

The researchers presented their findings in April at the American Academy of Neurology conference in Honolulu.


Age-related changes in the brain's white matter affect cognitive function

From around age 60, "white-matter lesions" appear in the brain, significantly affecting cognitive function. But without cognitive data from childhood, it is hard to know how much of the difference in cognitive abilities between elderly individuals is due to aging. A longitudinal study has been made possible by the Scottish Mental Survey of 1932, which gave 11-year-olds a validated cognitive test. Scottish researchers have tracked down healthy living men and women who took part in this Survey and retested 83 participants. Testing took place in 1999, when most participants were 78 years old.
It was found that the amount of white-matter lesions made a significant contribution to general cognitive ability differences in old age, independent of prior ability. The amount of white-matter lesions contributed 14.4% of the variance in cognitive scores; early IQ scores contributed 13.7%. The two factors were independent.
Although white-matter lesions are viewed as a normal part of aging, they are linked with other health problems, in particular to circulatory problems (including hypertension, diabetes, heart disease and cardiovascular risk factors).

[442] Deary, I. J., Leaper S. A., Murray A. D., Staff R. T., & Whalley L. J. (2003).  Cerebral white matter abnormalities and lifetime cognitive change: a 67-year follow-up of the Scottish Mental Survey of 1932. Psychology and Aging. 18(1), 140 - 148.

High sugar blood levels linked to poor memory

A new study takes an important step in explaining cognitive impairment in diabetics, and suggests a possible cause for some age-related memory impairment. The study assessed non-diabetic middle-aged and elderly people. Those with impaired glucose tolerance (a pre-diabetic condition) had a smaller hippocampus and scored worse on tests for recent memory. These results were independent of age or overall cognitive performance. The brain uses glucose almost exclusively as a fuel source. The ability to get glucose from the blood is reduced in diabetes. The study raises the possibility that exercise and weight loss, which help control blood sugar levels, may be able to reverse some of the memory loss that accompanies aging.

[543] Convit, A., Wolf O. T., Tarshish C., & de Leon M. J. (2003).  Reduced glucose tolerance is associated with poor memory performance and hippocampal atrophy among normal elderly. Proceedings of the National Academy of Sciences of the United States of America. 100(4), 2019 - 2022.

Diabetes and high blood pressure linked to decline in mental ability

A large-scale six-year study of people aged 40 to 70 years old found that people with diabetes and high blood pressure are more likely to experience cognitive decline. Diabetes was associated with greater cognitive decline for those younger than 58 as well as those older than 58, but high blood pressure was a risk factor only for the 58 and older group.

[2534] Knopman, D. S., Boland L. L., Mosley T., Howard G., Liao D., Szklo M., et al. (2001).  Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology. 56(1), 42 - 48.

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