Diabetes is a key risk factor for Dementia and Alzheimer’s Disease

I have many friends and patients who are petrified of developing dementia as they get older. Still, it is so hard for most of us to follow a low, inflammatory diet.

More and more studies, like the one below indicate the association with diabetes and Alzheimer’s disease.

Since diabetes type two is completely curable, we continue to recommend to all patients to cure their type two diabetes as quickly as possible.

The best way to do that is controversial. I do generally follow a low, inflammatory diet by trying to stay gluten-free, sugar-free, and mostly dairy free: I occasionally, though, have Greek yogurt and eggs. Also, I do intermittent fasting and only eat from noon to about 5 PM. 

But this is a new diet for me, relatively speaking one that I did not start after 40 years old. I wish I had started this lifestyle/diet sooner, 

SLC

Type 2 Diabetes and Biomarkers of Brain Structure, Perfusion, Metabolism, and Function in Late Mid-Life: A Multimodal Discordant Twin Study

Article type: Research Article

Authors: Karayiannis, Christopher C.a; b | Srikanth, Velandaib; c; k; * | Beare, Richardb; c; d | Mehta, Hemalf; g| Gillies, Markg | Phan, Thanh G.e | Xu, Zheng Yangf; h | Chen, Christinei; j | Moran, Chrisb; c; k; l; m

Affiliations: [a] Department of Medicine, Peninsula Health, Melbourne, Australia | [b] Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia | [c] National Centre for Healthy Ageing, Melbourne, Australia | [d] Developmental Imaging, Murdoch Children’s Research Institute, Melbourne, Australia | [e] Stroke and Ageing Research Centre, School of Clinical Sciences, Monash University, Melbourne, Australia | [f] Royal Free London NHS Foundation Trust, London, UK | [g] Macular Research Group, University of Sydney, Sydney, Australia | [h] UCL Medical School, London, UK | [i] Ophthalmology Department, Monash Health, Melbourne, Australia | [j] Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, Australia | [k] Department of Geriatric Medicine, Peninsula Health, Melbourne, Australia | [l] Department of Aged Care, Alfred Health, Melbourne, Australia | [m] School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

Correspondence: [*] Correspondence to: Professor Velandai Srikanth, Professor of Medicine, Peninsula Health, Academic Unit, Monash University, 2 Hastings Rd, Frankston 3199, Victoria, Australia. Tel.: +61 3 97881723; E-mail: velandai.srikanth@monash.edu.

Abstract: Background:Type 2 diabetes (T2D) is associated with an increased risk of dementia and early features may become evident even in mid-life. Characterizing these early features comprehensively requires multiple measurement modalities and careful selection of participants with and without T2D. 

Objective:We conducted a cross-sectional multimodal imaging study of T2D-discordant twins in late mid-life to provide insights into underlying mechanisms. 

Methods:Measurements included computerized cognitive battery, brain MRI (including arterial spin labelling, diffusion tensor, resting state functional), fluorodeoxyglucose (FDG)-PET, and retinal optical coherence tomography. Results:There were 23 pairs, mean age 63.7 (±6.1) years. In global analyses, T2D was associated with poorer attention (β= –0.45, p <0.001) and with reduced FDG uptake (β= –5.04, p = 0.02), but not with cortical thickness (p = 0.71), total brain volume (p = 0.51), fractional anisotropy (p = 0.15), mean diffusivity (p = 0.34), or resting state activity (p = 0.4). Higher FDG uptake was associated with better attention (β= 3.19, p = 0.01) but not with other cognitive domains. In regional analyses, T2D was associated with lower accumbens volume (β= –44, p = 0.0004) which was in turn associated with poorer attention. 

Conclusion:T2D-related brain dysfunction in mid-life manifests as attentional loss accompanied by evidence of subtle neurodegeneration and global reduction in cerebral metabolism, in the absence of overt cerebrovascular disease. 

Keywords: Alzheimer’s disease, cognitive dysfunction, dementia, multimodal imaging, twins, type 2 diabetes mellitus