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Diabetes And Dementia In Older Adults

Diabetes And Dementia - Is There A Connection?

Diabetes And Dementia - Is There A Connection?

Diabetes and dementia - is there a connection? Diabetes and dementia - is there a connection? What do diabetes and dementia have in common? Diabetes occurs when the body is unable to make enough insulin or use the insulin it makes properly. Insulin is a hormone used by the body to control glucose levels, or the amount of sugar, in your blood. Glucose is one of the main sources of fuel for the body, providing energy the body needs to perform all necessary functions. There are two main types of diabetes type 1 and type 2. A third type, gestational diabetes, occurs temporarily during pregnancy.Studies have shown that type 2 diabetes can be a risk factor for Alzheimers disease, vascular dementia and other types of dementia because cardiovascular problems associated with diabetes are also associated with dementia. These include: Heart disease or family history of heart disease Research has also proved that, similar to diabetes, glucose is not used properly in the brains of people with Alzheimers disease. This may be caused by nerve cell death, which reduces the brains ability to interpret messages.In the case of vascular dementia, brain cells die due to lack of oxygen, preventing brain cells from communicating with each other. Beta amyloid plaques, which build up in the brains of people with Alzheimers disease, have also been shown to prevent insulin receptors in the brain from doing their job. This can impact insulin production and cause brain cells to become insensitive to insulin. Is Alzheimers disease type 3 diabetes? Recent studies suggest that the brains of people with Alzheimers disease are in a diabetic state, partly due to the decrease in or insensitivity to insulin.There are many similarities in the brains of people with diabetes and the brains of people with Alzh Continue reading >>

Diabetes And Dementia

Diabetes And Dementia

With the number of over-65 Americans growing each day, it’s becoming ever more critical to spread awareness of the health changes that go along with aging, including the increased risks seniors face when they already suffer from a chronic disease. When that disease is diabetes — the seventh leading cause of death in the United States, according to the CDC — caregivers need to be particularly vigilant of their aging loved one’s health in order to minimize associated risks like cardiovascular disease and stroke. Now, unfortunately, we can add dementia to that list of risks. The Connection Between Diabetes and Dementia In two studies published in Diabetes Care and the Journal of the American Medical Association, researchers at the University of California, San Francisco, found a potentially dangerous connection between diabetes and dementia. The link between the two is hypoglycemia, or low blood sugar. “Hypoglycemia commonly occurs in patients with diabetes mellitus (DM) and may negatively influence cognitive performance,” says the JAMA study. “Cognitive impairment in turn can compromise DM management and lead to hypoglycemia.” Because the brain uses glucose for energy, cognitive function can be impaired when blood glucose drops too low; severe hypoglycemia can cause neuronal damage, say the study’s authors — possibly leading to neurological issues like Alzheimer’s disease and dementia. Diabetes affects the production and regulation of insulin, a hormone that helps with glucose absorption by the blood, and that puts diabetics at risk for hypoglycemia. The researchers found that diabetics who had experienced a hypoglycemic event severe enough to require hospitalization had a twofold increased risk for developing dementia over a 12-year follow-up period Continue reading >>

Many Older Veterans With Diabetes And Dementia May Have Tighter Glucose Control Than Is Safe

Many Older Veterans With Diabetes And Dementia May Have Tighter Glucose Control Than Is Safe

Many Older Veterans With Diabetes and Dementia May Have Tighter Glucose Control Than Is Safe Tight glycemic control and use of hypoglycemic medications in older veterans with type 2 diabetes and comorbid dementia, by Thorpe and colleagues. Diabetes Care. Electronically published ahead of print on 15 January 2015. What is the problem and what is known about it so far? Dementia is a group of age-related mental disorders that include memory problems, personality changes, and reasoning difficulties. People with diabetes have a greater chance of getting dementia than those without diabetes. In fact, dementia affects almost one-fourth of all people with diabetes who are 75 years old or older. Safely meeting the health care needs of people with diabetes and dementia can be a difficult task. People with both conditions are two to three times more likely than others to have severe hypoglycemia (low blood glucose) and preventable hospital stays. Taking steps to improve this, and especially to lower these patients' risk for hypoglycemia, is important. Current guidelines suggest that the tight level of glucose control recommended for most people with diabetes (namely, an A1C level less than 7 percent) may not be right for older people with diabetes and dementia. Tight control makes hypoglycemia more likely and may not offer much benefit to older people. Instead, these people should aim for a less-tight A1C goal of 7 to 9 percent. Older people with dementia and diabetes often have other risk factors for hypoglycemia, as well. Some have poor appetites and lose weight. Some may take certain diabetes medicines that make hypoglycemia more likely or may have trouble taking their medicines as directed. Many also have trouble recognizing and treating hypoglycemia when it occurs. Health ca Continue reading >>

Older People And Diabetes

Older People And Diabetes

Save for later Most areas of care in diabetes are relevant to all age groups but there are some specific changes due to growing older which might affect your diabetes. Food choices In some cases dietary advice for the older person with diabetes may differ from general recommendations. Older people in care homes are often more likely to be underweight than overweight and there is a high rate of undernutrition. It may not always be appropriate to reduce the fat, salt and sugar for every older person with diabetes. Poor or irregular eating can often be a cause of hypos. Poor oral health, effects of some drugs on the digestive system, limited mobility, dexterity or vision can all cause discomfort associated with eating. Fluid intake is often lower in older people which can cause dehydration, particularly during bouts of illness. People at risk should have a nutritional assessment and individual advice from a dietitian to address areas of concern such as needing extra calories, meal supplements and replacements, weight reduction, low salt diet or manageable foods. Nutritional assessment and diet should form part of your individual care plan if you live in a care home. Personal food preferences are important in any diet plan and older people with diabetes should be able to continue to enjoy a wide variety of foods. Staff, including catering staff in older people's care homes, should have training to give them an understanding of the specific needs of individuals with diabetes. Keeping active Keeping active in later life helps to strengthen muscles, maintain mobility and balance and improves insulin sensitivity. It can help you to continue to self-care, can improve your mental well-being and prevent falls. You can aim to be as active as you are able. Older people, including th Continue reading >>

Managing Cognitive Decline In Older Adults With Diabetes

Managing Cognitive Decline In Older Adults With Diabetes

Managing Cognitive Decline in Older Adults With Diabetes Associate Professor of Medicine, Divisions of Geriatrics & Endocrinology University of Miami Miller School of Medicine Hermes Florez, MD, PhD, MPH, has indicated to Physicians Weekly that he has received grants/research support from the NIH/Department of Health and Human Services, the Department of Veterans Affairs (Cooperative Study Program and Geriatric Research, Education, and Clinical CenterGRECC), the American Heart Association, the Pan American Health Organization, and the International Diabetes Federation. Associate Professor of Medicine, Divisions of Geriatrics & Endocrinology University of Miami Miller School of Medicine Hermes Florez, MD, PhD, MPH, has indicated to Physicians Weekly that he has received grants/research support from the NIH/Department of Health and Human Services, the Department of Veterans Affairs (Cooperative Study Program and Geriatric Research, Education, and Clinical CenterGRECC), the American Heart Association, the Pan American Health Organization, and the International Diabetes Federation. Older diabetic patients who have cognitive dysfunction should receive adjusted care that involves simplified treatment regimens and frequent surveillance. This Physicians Weekly feature on managing cognitive decline in older adults with diabetes was completed in cooperation with the experts at the American Diabetes Association. More than 25% of Americans aged 65 and older has diabetes, and the aging of the overall population has been identified as a significant driver of the diabetes epidemic. Diabetes in older adults is associated with higher mortality, reduced cognitive and functional status, and increased risk of institutionalization, explains Hermes Florez, MD, PhD, MPH. Importantly, diabete Continue reading >>

Update On Cognitive Decline And Dementia In Elderly Patients With Diabetes - Sciencedirect

Update On Cognitive Decline And Dementia In Elderly Patients With Diabetes - Sciencedirect

Volume 40, Issue 5 , November 2014, Pages 331-337 Update on cognitive decline and dementia in elderly patients with diabetes Author links open overlay panel L.Bordiera This article is an update of the relationship between type 2 diabetes (T2D), cognitive dysfunction and dementia in older people. The number of older patients consulting for diabetes who also exhibit cognitive difficulties is consistently growing because of the increased longevity of the population as a whole and, according to a number of studies, the increased risk of cognitive impairment and dementia in older diabetic patients. Many studies have demonstrated a link between poor glucose control and deteriorated cognitive function in diabetic patients. A history of severe hypoglycaemic episodes has also been associated with a greater risk of late-in-life cognitive deficits and dementia in patients with T2D. Several processes are thought to promote cognitive decline and dementia in diabetics. Based on both clinical and non-clinical findings, the factors most likely to alter brain function and structure are cerebrovascular complications of diabetes, alterations in glucose and insulin, and recurrent hypoglycaemia. Together with other diabetes complications, cognitive deficits contribute to functional impairment, increased frequency of depression-related symptoms, greater incidence of recurrent hypoglycaemia, poorer adherence to treatment and, finally, poorer prognosis, as evidenced by recent longitudinal studies. Clinical guidelines have recently been devised for older diabetic patients, particularly those with cognitive deficits and a reduced capacity to self-manage. In the most vulnerable patients, specific treatment strategies have been proposed for glycaemic control to limit metabolic decompensation and Continue reading >>

Study Suggests Association Between Hypoglycemia, Dementia In Older Adults With Diabetes

Study Suggests Association Between Hypoglycemia, Dementia In Older Adults With Diabetes

Study Suggests Association Between Hypoglycemia, Dementia in Older Adults With Diabetes EMBARGOED FOR RELEASE: 3 P.M. (CT), MONDAY, JUNE 10, 2013 Media Advisory: To contact Kristine Yaffe, M.D., call Jeffrey Norris at 415-476-8255 or email [email protected] . To contact commentary author Kasia J. Lipska, M.D., M.H.S., call Helen Dodson at 203-436-3984 or email [email protected] . CHICAGO A study of older adults with diabetes mellitus (DM) suggests a bidirectional association between hypoglycemic (low blood glucose) events and dementia, according to a report published Online First by JAMA Internal Medicine, a JAMA Network publication. There is a growing body of evidence that DM may increase the risk for developing cognitive impairment, including Alzheimer disease and vascular dementia, and there is research interest in whether DM treatment can prevent cognitive decline. When blood glucose declines to low levels, cognitive function is impaired and severe hypoglycemia may cause neuronal damage. Previous research on the potential association between hypoglycemia and cognitive impairment has produced conflicting results, the authors write in the study background. Kristine Yaffe, M.D., of the University of California, San Francisco, and colleagues studied 783 older adults with DM (average age 74 years). During a 12-year follow-up, 61 patients (7.8 percent) had a reported hypoglycemic event and 148 (18.9 percent) developed dementia. Hypoglycemia commonly occurs in patients with diabetes mellitus (DM) and may negatively influence cognitive performance. Cognitive impairment in turn can compromise DM management and lead to hypoglycemia, according to the study. Patients who experienced a hypoglycemic event had a two-fold increased risk for developing dementia compared with Continue reading >>

Dementia And Diabetes Are A Dangerous Combination

Dementia And Diabetes Are A Dangerous Combination

A chronic illness alone may seem like too much to cope with, but unfortunately, one chronic condition can often compound the effects of another. Diabetes is one such disease that increases a patient's risk of developing a whole slew of other conditions, especially cardiovascular disease. On its own, diabetes is the seventh leading cause of death in the U.S., according to the Centers for Disease Control and Prevention (CDC). It seems that among older adults with diabetes, there is also an association between low blood sugar (hypoglycemia) and dementia, say researchers at the University of California, San Francisco (UCSF) in a new study published in the Journal of the American Medical Association. This can create a dangerous spiral, in which a hypoglycemic event caused by diabetes can lead to mental deterioration and vice versa. “The brain uses glucose as a primary source of energy. Cognitive function becomes impaired when blood glucose drops to low levels, and severe hypoglycemia may cause neuronal damage,” the study authors wrote. Diabetes is a set of chronic conditions that affect the production and regulation of the hormone insulin. Insulin helps blood cells take up glucose, which means that for diabetics, getting glucose to the brain is a difficult task. If the brain is starved of energy, it’s possible that neurological problems like dementia and Alzheimer’s disease are more likely to develop. The UCSF researchers found that the relationship between dementia, Alzheimer’s, diabetes, and hypoglycemia is mutual. “We found that clinically significant hypoglycemia was associated with a two-fold increased risk for developing dementia…similarly, participants with dementia were more likely to experience a severe hypoglycemic event,” the study authors wrote. B Continue reading >>

Managing Diabetes In People With Dementia: Protocol For A Realist Review

Managing Diabetes In People With Dementia: Protocol For A Realist Review

Managing diabetes in people with dementia: protocol for a realist review Worldwide, the prevalences of diabetes and dementia are both increasing, particularly in older people. Rates of diabetes in people with dementia are between 13 and 20%. Diabetes management and diabetic self-care may be adversely affected by the presence of dementia. There is a need to know what interventions work best in the management of diabetes in people living with dementia (PLWD) in different settings and at different stages of the dementia trajectory. The overall aim is to develop an explanatory account or programme theory about what works in the management of diabetes in people in what context and to identify promising interventions that merit further evaluation. This study uses a realist approach including studies on the management of diabetes in older people, medication management, diabetes-related self-care, workforce issues and assessment and treatment. We will use an iterative, stakeholder driven, four-stage approach. Phase 1: development of initial programme theory/ies through a first scoping of the literature and consultation with key stakeholder groups (user/patient representatives, dementia-care providers, clinicians, diabetes and dementia researchers and diabetes specialists). Phase 2: systematic searches of the evidence to test and develop the theories identified in phase 1. Phase 3: validation of programme theory/ies with a purposive sample of participants from phase 1. Phase 4: actionable recommendations for the management of diabetes in PLWD. A realist synthesis of the evidence will provide a theoretical framework (i.e. an explanation of how interventions work, for whom, in what context and why) for practice and future research work that articulates the barriers and facilitato Continue reading >>

Type 2 Diabetes, Cognition, And Dementia In Older Adults: Toward A Precision Health Approach

Type 2 Diabetes, Cognition, And Dementia In Older Adults: Toward A Precision Health Approach

Type 2 Diabetes, Cognition, and Dementia in Older Adults: Toward a Precision Health Approach 1Department of Pathology, Stanford University, Palo Alto, CA 2Sticht Center on Aging, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC Author information Copyright and License information Disclaimer Copyright 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details. This article has been cited by other articles in PMC. IN BRIEF There has been a concurrent dramatic rise in type 2 diabetes and dementia in the United States, and type 2 diabetes shares common genetic and environmental risk factors and underlying pathology with both vascular and Alzheimers dementias. Given the ability to identify this at-risk population and a variety of potential targeted treatments, type 2 diabetes represents a promising focus for a precision health approach to reduce the impact of cognitive decline and dementia in older adults. A confluence of factors related to dietary changes, sedentary lifestyle, and an aging population in Western cultures has led to a rapid rise in the incidence of type 2 diabetes, a disease that carries enormous burden in terms of health and economic outcomes. Increasingly, type 2 diabetes is recognized as a major contributor to cognitive decline and dementia in older adults. As both type 2 diabetes and dementia reach epidemic proportions in the United States, the need to identify methods of prevention and treatment grows increasingly important. Recently, there has been an emphasis on precision medicine, a model of focused identification and treatment of disease based on individual risk, as it applies to dement Continue reading >>

Association Between Hypoglycemia, Dementia In Older Adults With Diabetes

Association Between Hypoglycemia, Dementia In Older Adults With Diabetes

Follow all of ScienceDaily's latest research news and top science headlines ! Association between hypoglycemia, dementia in older adults with diabetes A study of older adults with diabetes mellitus (DM) suggests a bidirectional association between hypoglycemic (low blood glucose) events and dementia. A study of older adults with diabetes mellitus (DM) suggests a bidirectional association between hypoglycemic (low blood glucose) events and dementia, according to a report published Online First by JAMA Internal Medicine. There is a growing body of evidence that DM may increase the risk for developing cognitive impairment, including Alzheimer disease and vascular dementia, and there is research interest in whether DM treatment can prevent cognitive decline. When blood glucose declines to low levels, cognitive function is impaired and severe hypoglycemia may cause neuronal damage. Previous research on the potential association between hypoglycemia and cognitive impairment has produced conflicting results, the authors write in the study background. Kristine Yaffe, M.D., of the University of California, San Francisco, and colleagues studied 783 older adults with DM (average age 74 years). During a 12-year follow-up, 61 patients (7.8 percent) had a reported hypoglycemic event and 148 (18.9 percent) developed dementia. "Hypoglycemia commonly occurs in patients with diabetes mellitus (DM) and may negatively influence cognitive performance. Cognitive impairment in turn can compromise DM management and lead to hypoglycemia," according to the study. Patients who experienced a hypoglycemic event had a two-fold increased risk for developing dementia compared with those who did not have a hypoglycemic event (34.4 percent vs. 17.6 percent). Older adults with DM who developed dementia Continue reading >>

Managing Diabetes In People With Dementia

Managing Diabetes In People With Dementia

The number of patients with both type 2 diabetes and dementia is rising, which poses new challenges in blood glucose monitoring and medicines administration. Continue reading >>

Low Blood Sugar May Trigger Dementia In Those With Diabetes

Low Blood Sugar May Trigger Dementia In Those With Diabetes

Fisher Center for Alzheimer's Research Foundation Browse our vast collection of articles. Simply select a category on the left and find a list of related articles on the right. Low Blood Sugar May Trigger Dementia in Those With Diabetes Older adults with diabetes who experience severe episodes of low blood sugar, or hypoglycemia, are at increased risk of developing Alzheimers disease and other forms of dementia, a new study shows. And those with diabetes and dementia are more likely to experience hypoglycemia. The results suggest that hypoglycemia and dementia can create a vicious cycle, in which low blood sugar damages the brain, which in turn makes people less able to manage their diabetes, leading in turn to more episodes of low blood sugar. Older patients with diabetes may be especially vulnerable to a vicious cycle in which poor diabetes management may lead to cognitive decline and then to even worse diabetes management, said Dr. Kristine Yaffe, the senior author. The findings, which appeared in the journal JAMA Internal Medicine, add to a growing body of evidence linking Type 2 diabetes to Alzheimers and other forms of dementia. Studies suggest that having diabetes may increase the risk for developing serious memory and thinking problems, including dementia. And some research has suggested that careful control of diabetes can help to prevent memory decline. In addition, low levels of blood sugar in the brain can trigger thinking problems and damage nerves. For this study, researchers at the University of California, San Francisco, studied 783 elderly men and women (average age 74) with diabetes. During the 12-year course of the study, about 8 percent had at least one episode of hypoglycemia, and 19 percent had developed Alzheimers or another form of dementia. The Continue reading >>

Is High Blood Sugar Damaging Your Brain?

Is High Blood Sugar Damaging Your Brain?

Did you know that diabetes is a risk factor for dementia and cognitive decline? But effectively managing diabetes could actually improve long-term brain health. In diabetes, blood glucose levels remain too high, either because the body does not make or becomes resistant to insulin. Over time, high glucose levels can have serious repercussions, such as heart disease and stroke. But lower them too much and you could face immediate and severe side effects including confusion and cognitive impairment and, possibly, an increased risk of long-term cognitive decline [1][2]. WHAT THE EVIDENCE SAYS Diabetics have up to 73% increased risk of dementia and a 100% higher risk of developing vascular dementia than non-diabetics [3][4–6]. The association between diabetes and dementia risk is even stronger in people with the APOE4 gene [5]. Diabetes can lead to subtle cognitive decline and, in patients with mild cognitive impairment ?, it increases the odds of progressing to dementia [7–9]. The side effects of diabetes can worsen confusion and cognitive impairment in people with dementia. Type 2 diabetes and Alzheimer's disease share certain characteristics, including impaired insulin signaling and oxidative stress [10]. Because of this, research is underway to evaluate whether some specific diabetes drugs including metformin [11], liraglutide [12], exenatide [13], and pioglitazone [14] can prevent or treat dementia even in patients without diabetes [7]. WHAT YOU CAN DO Strong research from multiple meta-analyses indicates that preventing or effectively managing diabetes is one of the most important things you can do to reduce dementia risk and protect your brain from cognitive decline [3][15-17]. Healthy diet, exercise, and weight control are the first steps of diabetes management Continue reading >>

Update On Cognitive Decline And Dementia In Elderly Patients With Diabetes - Em|consulte

Update On Cognitive Decline And Dementia In Elderly Patients With Diabetes - Em|consulte

Received:26August2013; accepted:5February2014 Update on cognitive decline and dementia in elderly patients with diabetes , J.Doucet b , J.Boudet c , B.Bauduceau a aEndocrinology Department, hpital Bgin, 69, avenue de Paris, 94160 Saint-Mand, France bGeriatric Therapy and Internal Medicine Department, hpital Saint-Julien, CHU de Rouen, 76031 Rouen cedex, France cMedical Endocrinology Department, Lilly France, boulevard Vital-Bouhot, 92521 Neuilly-sur-Seine cedex, France Corresponding author. Service dendocrinologie, hpital Bgin, 69, avenue de Paris, 94160 Saint-Mand, France. Tel.: +33 1 43 98 52 14. This article is an update of the relationship between type 2 diabetes (T2D), cognitive dysfunction and dementia in older people. The number of older patients consulting for diabetes who also exhibit cognitive difficulties is consistently growing because of the increased longevity of the population as a whole and, according to a number of studies, the increased risk of cognitive impairment and dementia in older diabetic patients. Many studies have demonstrated a link between poor glucose control and deteriorated cognitive function in diabetic patients. A history of severe hypoglycaemic episodes has also been associated with a greater risk of late-in-life cognitive deficits and dementia in patients with T2D. Several processes are thought to promote cognitive decline and dementia in diabetics. Based on both clinical and non-clinical findings, the factors most likely to alter brain function and structure are cerebrovascular complications of diabetes, alterations in glucose and insulin, and recurrent hypoglycaemia. Together with other diabetes complications, cognitive deficits contribute to functional impairment, increased frequency of depression-related symptoms, greater inciden Continue reading >>

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