Diabetes and Obesity Program, Garvan Institute of Medical Research, Department of Endocrinology, St Vincent's Hospital, 384 Victoria St, Darlinghurst, NSW 2010, Australia.
Ther Adv Endocrinol Metab. 2012 Dec;3(6):189-96. doi: 10.1177/2042018812469645.
Type 2 diabetes is common in older people and is associated with higher risk of both vascular dementia and Alzheimer's disease. This review examines the evidence for increased risk of dementia and mild cognitive impairment in patients with diabetes and the role of potential confounders. The relationship of diabetes and impaired fasting glucose with brain structure is also reviewed, focusing on longitudinal studies in older people. The pathophysiology underlying cognitive change in type 2 diabetes is examined with reference to vascular disease, hypoglycaemia, inflammation and insulin levels. Implications for clinical care in older people with diabetes are discussed, with a recommendation for cognitive evaluation as a routine part of end-organ, diabetes complication review.
2 型糖尿病在老年人中很常见，与血管性痴呆和阿尔茨海默病的风险增加有关。本综述检查了糖尿病患者痴呆和轻度认知障碍风险增加的证据，以及潜在混杂因素的作用。还回顾了糖尿病和空腹血糖受损与大脑结构的关系，重点是老年人的纵向研究。参考血管疾病、低血糖、炎症和胰岛素水平，检查了 2 型糖尿病认知改变的病理生理学。讨论了对老年糖尿病患者临床护理的影响，建议将认知评估作为终末器官、糖尿病并发症检查的常规内容。
