Skip to main content
Log in

Diabetes und Demenz

Diabetes and dementia

  • Beiträge zum Themenschwerpunkt
  • Published:
Zeitschrift für Gerontologie und Geriatrie Aims and scope Submit manuscript

Zusammenfassung

Diabetes mellitus ist ein bekannter Risikofaktor für kognitive Störungen und Demenzerkrankungen. Bei der Entwicklung kognitiver Störungen spielen neben der chronischen Hyperglykämie weitere Faktoren wie genetische Prädisposition, arterielle Hypertonie, Hyperlipoproteinämie, mikro- und makrovaskuläre Erkrankungen sowie die Depression eine wichtige Rolle. In der vorliegenden Übersichtsarbeit werden sowohl die pathophysiologische Zusammenhänge zwischen den Erkrankungen Diabetes und Demenz als auch die Besonderheiten der Diabetestherapie bei Demenzerkrankten differenziert dargestellt.

Abstract

Diabetes mellitus is a known risk factor for cognitive dysfunction and dementia. Chronic hyperglycemia, genetic predisposition, arterial hypertension, hyperlipoproteinemia, micro- and macrovascular diseases, and depression play a major role in the development of cognitive dysfunction. Both pathophysiology of diabetes and dementia and the specifics of diabetes therapy in patients with dementia are presented in this review.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1

Literatur

  1. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ (2001) The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 24(6):1069–1078

    Article  PubMed  CAS  Google Scholar 

  2. Barrou Z, Lemaire A, Boddaert J, Verny M (2008) Diabetes and cognition – is there a link? Psychol Neuropsychiatr Vieil 3:189–198

    Google Scholar 

  3. Black SA, Markides KS, Ray LA (2003) Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with type 2 diabetes. Diabetes Care 26(10):2822–2828

    Article  PubMed  Google Scholar 

  4. Bruce DG, Davis WA, Casey GP et al (2009) Severe hypoglycaemia and cognitive impairment in older patients with diabetes: the Fremantle Diabetes Study. Diabetologia 52:1808–1815

    Article  PubMed  CAS  Google Scholar 

  5. Braun A, Müller UA, Muller R et al (2004) Structured treatment and teaching of patients with type 2 diabetes mellitus and impaired cognitive function – the DICOF trial. Diabet Med 21(9):999–1006

    Article  PubMed  CAS  Google Scholar 

  6. Carmelli D, Swan GE, Reed T et al (1999) Midlife cardiovascular risk factors and brain morphology in identical older male twins. Neurology 52:1119–1124

    PubMed  CAS  Google Scholar 

  7. Currie CJ, Peters JR, Tynan A et al (2010) Survival as a function of HbA(1c) in people with type 2 diabetes: a retrospective cohort study. Lancet 375(9713):481–489

    Article  PubMed  CAS  Google Scholar 

  8. Ding J, Strachan MW, Reynolds RM et al; Edinburgh Type 2 Diabetes Study Investigators (2010) Diabetic retinopathy and cognitive decline in older people with type 2 diabetes. Diabetes 59(11):2883–2889

    Article  PubMed  CAS  Google Scholar 

  9. Elias PK, Elias MF, D’Augostino RB et al (1997) NIDDM and blood pressure as risk factors for poor cognitive performance. Diabetes care 20:1388–1395

    Article  PubMed  CAS  Google Scholar 

  10. Fernandez MM, Castro FJ, Perez HS de las (2008) Risk factors for dementia in the epidemiological study of Munguialde County (Basque Country Spain). BMC Neurology 8:39

    Article  Google Scholar 

  11. Forette F, Seux ML, Staessen J et al (1998) Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) Trial. Lancet 352:1347–1351

    Article  PubMed  CAS  Google Scholar 

  12. Gonzalez JS, Peyrot M, McCarl LA et al (2008) A depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care 31(12):2398–2403

    Article  PubMed  Google Scholar 

  13. Harrington C, Sawchak S, Chiang C et al (2011) Rosiglitazone does not improve cognition or global function when used as adjunctive therapy to AChE inhibitors in mild-moderate Alzheimer’s disease: two phase 3 studies. Curr Alzheimer Res 8(5):592–606

    Article  PubMed  CAS  Google Scholar 

  14. Hermanns N, Kulzer B, Krichbaum M et al (2005) Affective and anxiety disorders in a German sample of diabetic patients: prevalence, comorbidity and risk factors. Diabet Med 22(3):293–300

    Article  PubMed  CAS  Google Scholar 

  15. Hsiung GY, Sadovnik AD, Feldman H (2004) Apolipoprotein E epsiolon 4 genotype as risk factor for cognitive decline and dementia: data from the Canadian Study for Health and Ageing. Can Med Assoc J 171:863–867

    Article  Google Scholar 

  16. Jorm AF, Jolly D (1998) The incidence of dementia – a meta analysis. Neurology 51(3):728–733

    PubMed  CAS  Google Scholar 

  17. Kalmijn S, Foley D, White L et al (2000) Metabolic cardiovascular syndrome and risk of dementia in Japanese- American elderly men. The Honolulu-Asia Aging Study. Arterioscler Thromb Vasc Biol 20:2255–2260

    Article  PubMed  CAS  Google Scholar 

  18. Katon WJ, Lin EHB, Williams LH et al (2010) Comorbid depression is associated with an increased risk of dementia diagnosis in patients with diabetes: a prospective cohort study. J Gen Intern Med 25(5):423–429

    Article  PubMed  Google Scholar 

  19. Knol MJ, Twisk JWR, Beekman ATF et al (2006) Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia 49(5):837–845

    Article  PubMed  CAS  Google Scholar 

  20. Kopf D, Frölich M (2009) Risk of incident Alzheimer’s disease in diabetic patients: a systematic review of prospective trials. J Alzheimers Dis 16(4):677–685

    PubMed  Google Scholar 

  21. Kopf D (2009) Einfluss von Diabetes mellitus, Übergewicht und Bewegungsmangel auf Morbus Alzheimer – Interaktion von Insulin mit Amyloid und phosphoryliertem Tau-Protein. Klinikarzt 38:228–233

    Google Scholar 

  22. Kulzer B, Albus C, Herpertz S et al (2010) Psychosoziales und Diabetes mellitus. Praxisleitlinie der Deutschen Diabetesgesellschaft 5:139–145

    Google Scholar 

  23. Leonard BE (2007) Inflammation, depression and dementia: are they connected? Neurochem Res 32(10):1749–1756

    Article  PubMed  CAS  Google Scholar 

  24. Luchsinger JA, Reitz C, Honig LS et al (2005) Aggregation of vascular risk factors and risk of incident Alzheimer disease. Neurology 65:545–551

    Article  PubMed  CAS  Google Scholar 

  25. Marioni RE, Strachan MW, Reynolds RM et al (2010) Association between raised inflammatory markers and cognitive decline in elderly people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study. Diabetes 59:710–713

    Article  PubMed  CAS  Google Scholar 

  26. Mezuk B, Eaton WW, Albrecht S, Golden SH (2008) Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes Care 31(12):2383–2390

    Article  PubMed  Google Scholar 

  27. Murray AM, Barzilay JI, Lovato JF et al for the Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD-MIND) Substudy Investigators (2011) Biomarkers of renal function and cognitive impairment in patients with diabetes. Diabetes Care 34(8):1827–1832

    Article  PubMed  Google Scholar 

  28. Ott A, Stolk RP, Hofman A et al (1996) Association of diabetes and dementia. The Rotterdam Study. Diabetologia 39:1392–1397

    Article  PubMed  CAS  Google Scholar 

  29. Pasquier F, Boulogne A, Leys D, Fontaine P (2006) Diabetes mellitus and dementia. Diabetes Metab 32:403–414

    Article  PubMed  CAS  Google Scholar 

  30. Peila R, Rodriguez BL, Launer LJ; Honolulu-Asia Aging Study Type 2 diabetes (2002), APOE gene, and the risk for dementia and related pathologies. Diabetes 51:1256–1262

    Article  PubMed  CAS  Google Scholar 

  31. Reynolds RM, Strachan MW, Labad J et al (2010) Morning cortisol levels and cognitive abilities in people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study. Diabetes Care 33(4):714–720

    Article  PubMed  CAS  Google Scholar 

  32. Riederer P, Bartl J, Laux G, Grünblatt E (2011) Diabetes type II: a risk factor for depression, Parkinson, Alzheimer? Neurotox Res 19(2):253–265

    Article  PubMed  Google Scholar 

  33. Rönnemaa E, Zethelius B, Sundelöf J et al (2008) Impaired insulin secretion increases the risk of Alzheimer disease. Neurology 71:1065–1071

    Article  PubMed  Google Scholar 

  34. Rovio S, Kåreholt I, Helkala EL et al (2005) Leisure-time physical activity at midlife and the risk of dementia and Alzheimer’s disease. Lancet Neurol 4(11):705–711

    Article  PubMed  Google Scholar 

  35. Stewart R, Liolitsa D (1999) Type 2 diabetes mellitus, cognitive impairment, and dementia. Diabet Med 16:93–112

    Article  PubMed  CAS  Google Scholar 

  36. Strachan MWJ (2008) Diabetes, cognitive impairment, and dementia. BMJ 336:6

    Article  PubMed  Google Scholar 

  37. Strachan MW, Reynolds RM, Marioni RE, Price JF (2011) Cognitive function, dementia and type 2 diabetes mellitus in the elderly. Nat Rev Endocrinol 7:108–114

    Article  PubMed  CAS  Google Scholar 

  38. Whitmer RA, Karter AJ, Yaffe K et al (2009) Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA 301:1565–1572

    Article  PubMed  CAS  Google Scholar 

  39. Wörz E, Bahrmann A, Specht-Leible N, Oster P (2010) Struktur- und Behandlungsqualität von geriatrischen Patienten mit Diabetes mellitus im Pflegeheim. Diabetol Stoffwechs 5:66, P196

    Google Scholar 

  40. Xu W, Qiu C, Winblad B, Fratiglioni L (2007) The effect of borderline diabetes on the risk of dementia and Alzheimer’s disease. Diabetes 56:211–216

    Article  PubMed  CAS  Google Scholar 

  41. Zeyfang A, Bahrmann A, Wernecke J (2011) Diabetes mellitus im Alter. Praxisleitlinie der Deutschen Diabetesgesellschaft. Diabetol Stoffwechs 6:170–175

    Article  Google Scholar 

  42. Zeyfang A, Dippel W, Bahrmann A et al (2010) Aktuelle Versorgungssituation und Ressourcenbedarf bei insulinpflichtigen Typ-2-Diabetikern in stationärer und ambulanter Pflege: Ergebnisse der LIVE-GERI-Studie. Diabetol Stoffwechs 5:293–300

    Article  Google Scholar 

  43. Zuccala G, Pedone C, Cesari M et al (2003) The effects of cognitive impairment on mortality among hospitalized patients with heart failure. Am J Med 115:97–103

    Article  PubMed  Google Scholar 

  44. Zuccala G, Onder G, Pedone C et al (2001) Cognitive dysfunction as a major determinant of disability in patients with heart failure: results from a multicenter survey. J Neurol Neurosurg Psychiatry 70:109–112

    Article  PubMed  CAS  Google Scholar 

  45. Zuccala G, Onder G, Marzetti E et al (2005) Use of angiotensin-converting enzyme inhibitors and variations in cognitive performance among patients with heart failure. Eur Heart J 26:226–233

    Article  PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Die korrespondierende Autorin gibt an, dass kein Interessenkonflikt besteht. A.B. und P.B. sind Stipendiaten des Forschungskollegs Geriatrie der Robert-Bosch-Stiftung.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Bahrmann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bahrmann, A., Bahrmann, P., Kubiak, T. et al. Diabetes und Demenz. Z Gerontol Geriat 45, 17–22 (2012). https://doi.org/10.1007/s00391-011-0269-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00391-011-0269-z

Schlüsselwörter

Keywords

Navigation