Diabetes is associated with cerebrovascular but not Alzheimer's disease neuropathology

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• 作者：Erin L. Abner^a ; ^b ; ^c ; ^{erin.abner@uky.edu" class="auth_mail" title="E-mail the corresponding author} ; Peter T. Nelson^a ; ^d ; Richard J. Kryscio^a ; ^c ; Frederick A. Schmitt^a ; ^e ; David W. Fardo^a ; ^c ; Randall L. Woltjer^f ; ^g ; Nigel J. Cairns^h ; ⁱ ; Lei Yu^j ; ^k ; Hiroko H. Dodge^f ; ^l ; Chengjie Xiong^h ; ^m ; Kamal Masakiⁿ ; Suzanne L. Tyas^o ; David A. Bennett^j ; ^k ; Julie A. Schneider^j ; ^p ; Zoe Arvanitakis^j ; ^k
• 关键词：Diabetes ; Neuropathology ; Infarcts ; Autopsy ; Cognition ; Cerebrovascular ; Alzheimer
• 刊名：Alzheimer's & Dementia
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：12
• 期：8
• 页码：882-889
• 全文大小：397 K

文摘

The relationship of diabetes to specific neuropathologic causes of dementia is incompletely understood.

Methods

We used logistic regression to evaluate the association between diabetes and infarcts, Braak neurofibrillary tangle stage, and neuritic plaque score in 2365 autopsied persons. In a subset of >1300 persons with available cognitive data, we examined the association between diabetes and cognition using Poisson regression.

Results

Diabetes increased odds of brain infarcts (odds ratio [OR] = 1.57, P < .0001), specifically lacunes (OR = 1.71, P < .0001), but not Alzheimer's disease neuropathology. Diabetes plus infarcts was associated with lower cognitive scores at end of life than infarcts or diabetes alone, and diabetes plus high level of Alzheimer's neuropathologic changes was associated with lower mini-mental state examination scores than the pathology alone.

Discussion

This study supports the conclusions that diabetes increases the risk of cerebrovascular but not Alzheimer's disease pathology, and at least some of diabetes' relationship to cognitive impairment may be modified by neuropathology.