Maestre Gladys E
Dept. Biomedical Sciences, Div. Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville TX 78520.
Curr Geriatr Rep. 2017 Sep;6(3):188-195. doi: 10.1007/s13670-017-0216-y. Epub 2017 Jul 18.
The incidence of Alzheimer's disease and related disorders is expected to triple by 2050. People with type 2 diabetes and prediabetes have a higher risk of cognitive dysfunction, including Alzheimer's disease and vascular dementia. Controversy remains about when and how to prevent and treat cognitive dysfunction in people with or at high risk of diabetes.
In our review of ongoing clinical trials, we have found that there has been an increase in the number of studies assessing the efficacy of pharmacological and non-pharmacological approaches to prevent or slow down cognitive impairment among people with or at high risk of diabetes.
Despite the considerable risk of cognitive impairment in people with diabetes and prediabetes, there is not enough evidence to support a specific treatment to prevent or slow mild cognitive impairment, or progression to Alzheimer's disease or related disorders. Several ongoing trials are attempting to identify the usefulness of several compounds, as well as lifestyle changes including exercise and diet. Direct mechanisms linking diabetes to cognitive decline have not been elucidated.
预计到2050年,阿尔茨海默病及相关疾病的发病率将增至三倍。2型糖尿病患者和糖尿病前期患者发生认知功能障碍(包括阿尔茨海默病和血管性痴呆)的风险更高。对于何时以及如何预防和治疗糖尿病患者或糖尿病高危人群的认知功能障碍,仍存在争议。
在我们对正在进行的临床试验的综述中,我们发现评估药物和非药物方法预防或减缓糖尿病患者或糖尿病高危人群认知障碍疗效的研究数量有所增加。
尽管糖尿病患者和糖尿病前期患者存在相当大的认知障碍风险,但尚无足够证据支持采用特定治疗方法来预防或减缓轻度认知障碍,或预防其进展为阿尔茨海默病或相关疾病。几项正在进行的试验正试图确定几种化合物以及包括运动和饮食在内的生活方式改变的有效性。糖尿病与认知衰退之间的直接机制尚未阐明。