Poorly
Controlled Diabetes Could Lead to Dementia in
Elderly
Poorly controlled diabetes seems to cause cognitive
problems in the elderly, a new study reports.
The
researchers determined that the main reason why
diabetic people age 60 and older scored low on
a cognitive function test was because of improper
management of their disease.
"We
knew that there was an association between diabetes
and dementia in older people," said Yousef
Mohammad, a study co-author and an assistant professor
of neurology at Ohio State University. "But
we found out that there is a difference in cognitive
capability between diabetics whose disease is
under control and those whose disease isn't adequately
controlled."
According
to the Centers for Disease Control and Prevention,
more than 16 million people in the United States
have diabetes and about 800,000 new cases are
diagnosed each year.
"The
prevalence of dementia will likely increase as
the U.S. population ages," he said. "Diabetes
is already on the rise."
The
researchers presented their findings in April
at the American Academy of Neurology conference
in Honolulu.
They
evaluated the association between diabetes mellitus
status and cognitive function in 2,583 adults
aged 60 and older who had participated in the
third National Health and Nutrition Examination
Survey, an ongoing study sponsored by the Centers
for Disease Control and Prevention.
The
participants were grouped according to their diabetic
status: poorly controlled diabetes; adequately
controlled diabetes; those with impaired glucose
tolerance, when blood glucose levels are between
normal and diabetic levels; and a non-diabetic
control group.
The
researchers ran blood glucose tolerance tests
and hemoglobin A1C measurements on each participant.
The hemoglobin A1C test tells a doctor whether
or not the patient's glucose levels are under
control, while a blood glucose tests indicates
if a patient's glucose tolerance is impaired.
Cognitive
ability was measured by a series of questions,
including asking participants who and where he
was; if he could remember objects he had seen
a few minutes earlier; if he could complete simple
addition and subtraction problems; and if he could
recall a story he had heard five minutes earlier.
Eight
percent (205) of the participants scored low on
the cognitive abilities test. It turned out that
only those participants with poorly controlled
diabetes had low scores on the cognitive abilities
test.
Mohammad
said the next step is to find out if getting mismanaged
diabetes under control can reverse dementia associated
with the disease.
"Many
diabetics take insulin or other hypoglycemic drugs,
but the disease still isn't controlled,"
he said. "It could be that these patients
aren't taking their medications properly, or that
they're not taking a strong enough dose."
While
the association between dementia and diabetes
is clear, researchers don't fully understand the
mechanism of how diabetes triggers dementia.
"If
we can help diabetics control their disease, then
we may be able to lower the incidence of dementia
in this population," Mohammad said. "That's
crucial, because treatment for dementia is very
limited."
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