Rush Memory Clinic, Rush Alzheimer's Disease Center, 1750 W. Harrison Street, Suite 1000, Chicago, IL, 60612, USA.
Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
Curr Neurol Neurosci Rep. 2020 Nov 5;20(12):64. doi: 10.1007/s11910-020-01085-9.
Research has consistently shown that type 2 diabetes (T2D) is associated with increased risk of all-cause dementia. Because one of the most common clinical presentations of early stage dementia is memory impairment, we examined the relationship of T2D with memory function, using the recently published scientific literature.
We conducted a structured review to identify studies of "T2D and memory" published since 2015. After review of the 129 articles retrieved, we identified 14 studies meeting the inclusion and exclusion criteria. Among the eight studies with a single assessment of memory function in time (mostly cross-sectional), six found an association of T2D with lower memory function, but mostly in select subgroups of persons. Separately, six studies included repeated measures of memory (longitudinal design). Four out of six longitudinal studies found that T2D was related with a faster decline in memory, while two did not. Among the four studies showing a relation with memory decline, two had sample sizes of 9000-10,000 persons. Further, three longitudinal studies controlled for hypertension and stroke as covariates, and results suggested that common vascular risk factors and diseases do not account for the relation. While mechanistic studies clearly support a role for cerebrovascular disease in the relation of T2D with cognition, emerging data suggest that insulin resistance in the brain itself may also play a role. Most, but not all, recently published studies suggest that T2D is associated with a lower level and faster decline in memory function. This association does not appear to be fully accounted for by common vascular processes. More research will clarify the mechanisms linking T2D to memory and dementia.
研究一致表明 2 型糖尿病（T2D）与全因痴呆风险增加相关。由于痴呆早期最常见的临床表现之一是记忆障碍，我们使用最新发表的科学文献来研究 T2D 与记忆功能的关系。
我们进行了一项结构审查，以确定自 2015 年以来发表的关于“T2D 和记忆”的研究。在回顾了检索到的 129 篇文章后，我们确定了符合纳入和排除标准的 14 项研究。在八项具有单一记忆功能评估的研究中（大多为横断面研究），有六项研究发现 T2D 与较低的记忆功能相关，但主要局限于特定亚组人群。另外，六项研究包括记忆的重复测量（纵向设计）。六项纵向研究中有四项发现 T2D 与记忆下降有关，而两项则没有。在四项显示与记忆下降相关的研究中，有两项的样本量为 9000-10000 人。此外，三项纵向研究将高血压和中风作为协变量进行了控制，结果表明常见的血管危险因素和疾病并不能解释这种关系。虽然机制研究清楚地表明脑血管疾病在 T2D 与认知之间的关系中起作用，但新出现的数据表明，大脑本身的胰岛素抵抗也可能起作用。大多数（但不是全部）最近发表的研究表明，T2D 与记忆功能的较低水平和较快下降相关。这种关联似乎不能完全由常见的血管过程来解释。更多的研究将阐明将 T2D 与记忆和痴呆联系起来的机制。
