(Press-News.org) People diagnosed with diabetes in midlife are more likely to experience significant memory and cognitive problems during the next 20 years than those with healthy blood sugar levels, new Johns Hopkins Bloomberg School of Public Health research suggests.
The researchers found that diabetes appears to age the mind roughly five years faster beyond the normal effects of aging. For example, on average, a 60-year-old with diabetes experiences cognitive decline on par with a healthy 65-year-old aging normally. Decline in memory, word recall and executive function is strongly associated with progression to dementia, a loss of mental capacity severe enough to interfere with a person's daily functioning.
A report on the research is published in the Dec. 2 issue of the journal Annals of Internal Medicine. The study is believed to be the longest of its kind following a cross-section of adults as they age.
"The lesson is that to have a healthy brain when you're 70, you need to eat right and exercise when you're 50," says study leader Elizabeth Selvin, PhD, MPH, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. "There is a substantial cognitive decline associated with diabetes, pre-diabetes and poor glucose control in people with diabetes. And we know how to prevent or delay the diabetes associated with this decline."
For the study, Selvin and the team used data from the Atherosclerosis Risk in Communities Study (ARIC), which in 1987 began following a group of 15,792 middle-aged adults in communities in Maryland, North Carolina, Minnesota and Mississippi. Participants were seen at four visits approximately three years apart beginning between 1987 and 1989, and were seen a fifth time between 2011 and 2013. Cognitive function was evaluated at visits two (1990-1992), four (1996-1998) and at visit five.
The researchers compared the amount of cognitive decline associated with aging with the amount of decline found in the ARIC participants. They determined that there was 19 percent more decline than expected in those participants with poorly controlled diabetes, as well as smaller declines for those with controlled diabetes and pre-diabetes. The outcomes were the same whether the participants were white or black.
Selvin says the results underscore the importance of using a combination of weight control, exercise and a healthy diet to prevent diabetes. Even losing just five to 10 percent of body weight, she says, can keep someone from developing diabetes. Diabetes is a function of elevated sugar (glucose) levels in the blood. This excess glucose can damage tissues and the vascular system throughout the body and diabetes is associated with blindness, nerve damage in the extremities and kidney disease. While diabetes can often be controlled through medication, exercise and changes to diet, disease prevention is the preferred goal.
"If we can do a better job at preventing diabetes and controlling diabetes, we can prevent the progression to dementia for many people," Selvin says. "Even delaying dementia by a few years could have a huge impact on the population, from quality of life to health care costs."
Nationwide, dementia costs in 2010 were estimated to be upwards of $159 billion a year and, with the aging of the population, are expected to increase by nearly 80 percent by 2040.
Researchers are increasingly aware of the importance of many other causes of dementia besides Alzheimer's disease, particularly cognitive impairment linked to abnormalities in blood vessels in the brain.
"There are many ways we can reduce the impact of cerebral blood vessel disease -- by prevention or control of diabetes and hypertension, reduction in smoking, increase in exercise and improvements in diet," says co-author A. Richey Sharrett, MD, DrPH, an adjunct professor at the Johns Hopkins Bloomberg School of Public Health. "Knowing that the risk for cognitive impairments begins with diabetes and other risk factors in mid-life can be a strong motivator for patients and their doctors to adopt and maintain long-term healthy practices."
Research has shown that the single best predictor of type 2 diabetes is being obese or overweight and, in the United States alone, more than one-third of adults (more than 72 million people) are obese, defined as having a Body Mass Index of 30 or more about 30 pounds overweight. Meanwhile, the diabetes epidemic has grown rapidly over the past several decades, affecting approximately 10 percent of American adults (21 million people).
INFORMATION:
"Diabetes in midlife and cognitive change over 20 years: the Atherosclerosis Risk in Communities Neurocognitive Study," was written by Andreea M. Rawlings, MS; A. Richey Sharrett, MD, DrPH; Andrea L.C. Schneider, PhD; Josef Coresh, MD, PhD, MHS; Marilyn Albert, PhD; David Couper, PhD, MS; Michael Griswold, PhD; Rebecca F. Gottesman, MD, PhD; Lynne E. Wagenknecht, DrPH, MPH; B. Gwen Windham, MD; and Elizabeth Selvin, PhD, MPH.
ARIC is carried out as a collaborative study supported by contracts with the National Institutes of Health's National Heart, Lung, and Blood Institute contracts. Neurocognitive data collection was supported by NHLBI grants (U01HL096812, HL096814, HL096899, HL096902, HL096917 and R01HL70825). The research was also supported by an NHLBI training grant (T32 HL007024), the NIH's National Institute of Diabetes and Digestive and Kidney Diseases (R01DK089174), and the NIH's National Institute on Aging (R01AG040282).
1. Better glucose control in midlife may protect against cognitive decline later in life
Having diabetes or prediabetes in midlife is associated with a greater risk for cognitive decline later in life, according to a study published in Annals of Internal Medicine. Approximately 10 percent of the U.S. population has type 2 diabetes, putting them at risk for several adverse health outcomes, including dementia. Cognitive decline is a precursor to dementia. Hemoglobin A1c (HbA1c) level is a measure of the average circulating glucose level in the blood over the preceding 2 ...
While policymakers and health care professionals have identified health information exchanges -- organizations that facilitate the sharing of patient medical information electronically between different organizations -- as a promising solution to fragmented health care delivery in the United States, a RAND Corporation review found that few of the more than 100 such organizations have been evaluated.
The relatively few exchanges that have been examined show some evidence of reducing emergency department costs and usage, but other outcomes are unknown, according to the ...
Over 75 million adults in the US are obese. These individuals are predisposed to health complications, including diabetes, heart disease, and cancer. Gastric bypass surgery results in dramatic weight loss and can improve diabetes symptoms in obese patients. A new study in the Journal of Clinical Investigation reveals that exercise following bypass surgery provides additional benefit for obese patients. Bret Goodpaster and colleagues at the University of Pittsburgh conducted a study on individuals that had recently undergone gastric bypass surgery. One group followed a moderate ...
Premature ovarian failure (POF) is estimated to affect 1-4% of the female population. Women with POF can present with a variety of symptoms and many genes have been linked to this condition. A new study in the Journal of Clinical Investigation identifies a specific mutation in a family that results in POF. Aleksandar Rajkovic and colleagues at the University of Pittsburgh studied 3 sisters with POF-associated symptoms and identified and mutation in MCM8, a gene involved in chromosome maintenance. Siblings without the MCM8 mutation did not have any signs of POF. Cells from ...
ORLANDO, Fla., December 1, 2014 - A new study by researchers at the Florida Hospital - Sanford-Burnham Translational Research Institute for Metabolism and Diabetes (TRI-MD) shows that patients who moderately exercise after bariatric surgery (weight-loss surgery) gain additional health improvements in glucose metabolism and cardiorespiratory fitness compared to patients who lead a sedentary lifestyle after surgery. The findings confirm the physiological and potential clinical benefits of adding an exercise regime following weight-loss surgery.
"This is the first randomized, ...
(NEW YORK - December 1, 2014) Kidneys donated by people born with a small variation in the code of a key gene may be more likely, once in the transplant recipient, to accumulate scar tissue that contributes to kidney failure, according to a study led by researchers at the Icahn School of Medicine at Mount Sinai and published today in the Journal of Clinical Investigation.
If further studies prove the variation to cause fibrosis (scarring) in the kidneys of transplant recipients, researchers may be able to use it to better screen potential donors and improve transplant ...
Treatment with the anticholesterol medicine rosuvastatin calcium did not reduce the risk of fracture among men and women who had elevated levels of an inflammatory biomarker, according to a report published online by JAMA Internal Medicine.
Fractures resulting from the bone-weakening disease osteoporosis are a burden facing an aging population. Cardiovascular disease (CVD) and osteoporosis may share common biological pathways with inflammation key to the development of atherosclerosis (hardening of the arteries) and possibly the development of osteoporosis. Several studies ...
Parents of children who fell at home were more likely not to use safety gates and not to have taught their children rules about climbing on things in the kitchen, according to a study published online by JAMA Pediatrics.
Falls send more than 1 million children in the United States and more than 200,000 children in the United Kingdom to emergency departments (EDs) each year. Costs for falls in the U.S. were estimated at $439 million for hospitalized children and $643 million for ED visits in 2005. Most of the falls involve beds, chairs, baby walkers, bouncers, changing ...
PROVIDENCE, R.I. [Brown University] -- If decades of effort to bring more underrepresented minority students into science, technology, engineering and mathematics (STEM) fields were considered a grand chemistry experiment, then the modest results would suggest that while the formula may not be wrong, it may well be incomplete, according to a new article in the journal CBE-Life Sciences Education.
"I don't necessarily want to say that we've been doing it wrong all along, it's just that there are other ideas we can bring in," said lead author Andrew G.Campbell, a Brown ...
Turn on any local TV weather forecast and you can get a map of where skies are blue or cloudy. But for scientists trying to figure out how clouds affect the Earth's environment, what's happening inside that shifting cloud cover is critical and hard to see.
To investigate the layers and composition of clouds and tiny airborne particles like dust, smoke and other atmospheric aerosols, , scientists at NASA's Goddard Space Flight Center in Greenbelt, Maryland have developed an instrument called the Cloud-Aerosol Transport System, or CATS. The instrument, which launches to ...
