Surgery News

Metabolic and neurological disorders may share common risk factors

January 06, 2016

"The greatest dementia risk was found in underweight individuals at older ages. These findings suggest the predictive ability of BMI changes across time," the authors write. "These results help explain the 'obesity paradox' as differences in dementia risk across time are consistent with physical changes in the trajectory toward disability."

( Arch Neurol . 2009;66[3]:336-342.

Heart Disease Risk Factors Associated With Faster Cognitive Decline

Individuals with higher total and low-density lipoprotein (LDL, or "bad") cholesterol levels and a history of diabetes appear to experience a more rapid cognitive decline after developing Alzheimer's disease. Elizabeth P. Helzner, Ph.D, and colleagues at the Columbia University Medical Center, New York, studied 156 patients who were diagnosed with Alzheimer's disease at an average age of 83.

During an average of 3.5 years of follow-up, those who had higher LDL and total cholesterol levels before diagnosis experienced a more rapid decline on cognitive test scores than those whose cholesterol levels were in the normal range, as did those with a history of diabetes when compared with those without diabetes.

The study "provides further evidence for the role of vascular risk factors in the course of Alzheimer's disease," the authors conclude. "Prevention or treatment of these conditions can potentially slow the course of Alzheimer's disease."

( Arch Neurol . 2009;66[3]:343-348.

Review: Insulin Resistance May Links Metabolic and Cognitive Disorders

Insulin resistance, when tissues in the body lose sensitivity to the hormone that regulates glucose, may underlie both dementia and metabolic disorders such as obesity and diabetes. In a review article, Suzanne Craft, Ph.D., of Veterans Administration Puget Sound Health Care System and University of Washington School of Medicine, Seattle, writes that "considerable progress has been made in establishing relationships among metabolic disorders and late-life dementing illnesses," including through the common foundation of insulin resistance.

"A number of challenges must be addressed as we move forward to determine the key mechanisms underlying these associations," Dr. Craft concludes, including establishing clear definitions of both metabolic and neurological conditions. "Future research aimed at identifying mechanisms that underlie comorbid associations will not only provide important insights into the causes and interdependencies of late-life dementias, but will also inspire novel strategies for treating and preventing these disorders."

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