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Felicia Goldstein, PhD:
Getting a diagnosis of Alzheimer’s disease is absolutely devastating to a family member.
Felicia Goldstein, a neuropsychologist at Emory School of Medicine, routinely sees the impact Alzheimer’s and other forms of dementia can have, and says uncontrolled diabetes has long been a major risk factor for cognitive impairment.
The idea that elevated glucose levels are associated with a higher risk for cardiac disease, for cardiovascular disease, for damage to vessels, important for providing the brain with adequate blood supply, adequate oxygen levels -- all of that’s important. If a person has the disease, has diabetes, then everything they can do to get that under good control is important.
But recent studies go even further, drawing a link between the body’s inability to utilize insulin properly and toxic proteins that form in the brain and destroy memory receptors. So just as a buildup of high glucose can lead to damage in other parts of the body, some researchers now believe it may play a role in clogging brain cells with plaques commonly found in Alzheimer’s patients. Many experts go as far as to call Alzheimer’s “type 3 diabetes."
It’s important to emphasize that an association is not a cause, that these are risk factors, meaning that if you have it -- diabetes for example -- you may be at greater risk than the general population, but it should not be interpreted as meaning that you are going to get Alzheimer’s disease.
Alzheimer’s currently has no cure and, like type 2 diabetes, is on the rise.
Alzheimer’s tends to start to affect the brain structures important for memory and particularly the hippocampus, arterial cortex -- structures that are involved in the encoding and retrieval of information. Later as the disease progresses, you start to see other areas come into play as well, including reasoning and problem solving, language, word-finding, etc. So we believe it starts out pretty specific, but it starts to involve more and more brain structures as the disease continues.
There is still much that is not known about how diabetes and Alzheimer’s disease are related, but experts are beginning to connect the dots and are fairly confident that adopting a healthy lifestyle, especially before middle age, will reduce the odds of bad outcomes from either disease.
It suggests that we can do something like developing new treatments for Alzheimer’s that take this compelling new research into account. Maybe we don’t have a cure for it yet, but I think we can affect the trajectory and help people that way.