Type 2 diabetes, related conditions, in relation and dementia: An opportunity for prevention?
Abstract
This manuscript provides a comprehensive review of the epidemiologic evidence linking type 2 diabetes (T2D) and its precursor conditions, elevated adiposity and hyperinsulinemia, to dementia. The mechanisms relating these conditions to dementia may be vascular and non-vascular. Elevated adiposity in middle age is related to a higher risk of dementia but the data on this association in old age is conflicting. Several studies have shown that hyperinsulinemia, a consequence of higher adiposity and insulin resistance, is also related to a higher risk of dementia, including late onset Alzheimer's disease (LOAD). Studies have consistently shown a relation of T2D with higher dementia risk, but the associations are stronger for vascular dementia compared to LOAD. A large proportion of the world population may be at increased risk of dementia given the trends for increasing prevalence of overweight, obesity, hyperinsulinemia, and T2D. However, these associations may present a unique opportunity for prevention and treatment of dementia. There are several known modalities that are effective in the prevention and T2D and the reduction of hyperinsulinemia including lifestyle interventions, metformin, thiazolideniodones, and acarbose. Several studies in the prevention and treatment of T2D are currently measuring cognitive outcomes and will provide information on whether T2D treatment and prevention can prevent cognitive decline and dementia.
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Diabetes and hyperinsulinemia may be risk factors for Alzheimer's disease.
“Diabetes and hyperinsulinemia may be risk factors for Alzheimer's disease (AD).”
From Metformin in Amnestic Mild Cognitive Impairment: Results of a Pilot Randomized Placebo Controlled Clinical Trial (2016) · cites this paper as [11]
Type 2 diabetes and its correlates and antecedents, insulin resistance and elevated adiposity, have shown strong associations with Alzheimer's disease in observational studies.
“Type 2 diabetes (T2D) and its correlates and antecedents, insulin resistance and elevated adiposity (overweight and obesity) have shown strong associations with AD in observational studies [10, 11].”
From Metformin in Amnestic Mild Cognitive Impairment: Results of a Pilot Randomized Placebo Controlled Clinical Trial (2016) · cites this paper as [11]
The finding that diabetes and insulin resistance are related to an increased risk of Alzheimer's dementia has prompted the exploration of related strategies for treatment and prevention of Alzheimer's disease.
“The finding that diabetes and insulin resistance are related to an increased risk of Alzheimer's dementia has prompted the exploration of related strategies for treatment and prevention of AD [11].”
From Metformin in Amnestic Mild Cognitive Impairment: Results of a Pilot Randomized Placebo Controlled Clinical Trial (2016) · cites this paper as [11]
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Therapeutic Approaches of Leptin in Alzheimers Disease
Carro, E. (2009) · Recent Patents on CNS Drug Discovery · doi:10.2174/157488909789104848 · Cited by 21 · see citing works
White Matter Ischemia: Time to Begin Integrating Experimental and Clinical Data
Pantoni, L. (2006) · European Neurology · doi:10.1159/000095542 · Cited by 15 · see citing works
Trials that matter: Rosiglitazone, ramipril, and the prevention of type 2 diabetes
Nathan, D. M., & Berkwits, M. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-6-200703200-00015 · Cited by 14 · see citing works
Rabiner, E. A., Tzimopoulou, S., Cunningham, V. J., et al. (2009) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2009.05.642 · Cited by 7 · see citing works
Prediction of Incident Diabetes Mellitus in Middle-aged Adults: The Framingham Offspring Study
Wilson, P. W. F. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.10.1068 · Cited by 4 · see citing works
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Chatterjee, S., Peters, S. A. E., Woodward, M., Mejia Arango, S., Batty, G. D., Beckett, N., Beiser, A., Borenstein, A. R., Crane, P. K., Haan, M., et al. (2016) · Diabetes Care · doi:10.2337/dc15-1588 · Cited by 711 · see citing works
Campbell, J. M., Stephenson, M. D., de Courten, B., Chapman, I., Bellman, S. M., & Aromataris, E. (2018) · Journal of Alzheimer s Disease · doi:10.3233/jad-180263 · Cited by 292 · see citing works
Luchsinger, J. A., Perez, T., Chang, H., Mehta, P., Steffener, J., Pradabhan, G., Ichise, M., Manly, J., Devanand, D. P., & Bagiella, E. (2016) · Journal of Alzheimer's Disease · doi:10.3233/jad-150493 · Cited by 285 · see citing works
“However, it seems reasonable to speculate that the negative vascular effects of rosiglitazone [67], including cerebrovascular effects, may have eclipsed the beneficial effects on AD [11].”
InfluentialSelf-citationde la Monte, S. M. (2012) · Drugs · doi:10.2165/11597760-000000000-00000 · Cited by 265 · see citing works
Baker, L. D., Barsness, S. M., Borson, S., Merriam, G. R., Friedman, S. D., Craft, S., & Vitiello, M. V. (2012) · Archives of Neurology · doi:10.1001/archneurol.2012.1970 · Cited by 138 · see citing works
Kehoe, P. G. (2018) · Journal of Alzheimer’s Disease · doi:10.3233/jad-171119 · Cited by 133 · see citing works
Zhao, R. R., O’Sullivan, A. J., & Fiatarone Singh, M. A. (2018) · European Review of Aging and Physical Activity · doi:10.1186/s11556-018-0190-1 · Cited by 88 · see citing works
- Authors
- Luchsinger, J. A.
- Affiliations
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA. Taub Institute for Research of Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA. Division of General Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA. Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, USA
- Venue
- Journal of Alzheimer s Disease
- Publisher
- SAGE Publications
- Published
- 2010-05-26
- Volume
- 20
- Issue
- 3
- Pages
- 723-736
- ISSN
- 1387-2877 (ISSN-L)
- 1875-8908
- OpenAlex
- W1578034565
- Cited by
- 91
- References
- 94
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 2 · 2022: 5 · 2021: 7 · 2020: 4 · 2019: 6 · 2018: 3 · 2017: 7 · 2016: 8 · 2015: 8 · 2014: 6 · 2013: 16 · 2012: 4
- FWCI
- 6.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Alzheimer s Disease (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (P01AG007232, R01AG026413, AG 07232, AG026413)
- National Institute on Minority Health and Health Disparities (P60MD00206, P60MD000206)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- type 2 diabetes, dementia
- MeSH terms
- Animals, Cognition Disorders, Dementia, Diabetes Mellitus, Type 2, Humans, Hyperinsulinism, Insulin Resistance, Obesity, Risk Factors, Adiposity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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