Sunday 13 December 2009, 23:11

Diabetes is a risk factor for MCI

How diabetes may promote the progression of cognitive impairment

Diabetes is a risk factor for MCI

A recent research study conducted by Rosebud O. Roberts and collaborators at the Mayo Clinic of Rochester (Minnesota, USA) demonstrates that there exists an association between onset, duration and severity of diabetes and Mild Cognitive Impairment (MCI).


Mild Cognitive Impairment is a transitional stage between normal cognitive aging and dementia, which is typically not diagnosed in routine clinical practice. Since curative treatments for dementia are not currently available, it is important to identify manageable risk factors associated with cognitive impairment, in order to intervene and prevent the progression from preclinical stage (MCI) to clinical disease (dementia).


Many studies have suggested a relationship between diabetes and cognitive impairment, although this association has not always been confirmed. However the recent study conducted by the US researchers was able to relate onset, duration and severity of diabetes to the pathogenesis of MCI.


The researchers found out that earlier onset (before 65 years of age), longer duration and greater severity of diabetes affect the onset of MCI and its progression to dementia. By contrast, when diabetes develops later, has been lasting for lesser time and/or is well-managed and treated, its influence on cognitive impairment may be not important.


Various hypothesis have been proposed to explain these findings. Longer duration and greater severity of diabetes may be associated with greater cerebral micro- and macrovascular damages, that may impair cognitive function.


Additional pathogenetic mechanisms, other than vascular disease, may play a role in the development of MCI in diabetic patients. Diabetes is associated with increased generation, deposition and aggregation of beta-amyloid in the brain, with consequent formation of amyloid plaques, that are implicated in a numeber of neurodegenerative disorders, such as Alzheimer's disease. Moreover diabetes impairs heart function: this may lead to episodes of cerebral anoxia, with consequent neuronal cell dysfunction or even degeneration and death.


All the mechanisms described above may independently increase the risk of cognitive impairment, but which order they come into play, at what extent and under which conditions is still an open problem.


By Chiara De Carli

Category: Diabetes

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