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At Columbia, Stern is co-directing a powerful study: Hundreds of aging New York City residents agreed to regular testing while they were still healthy, allowing scientists to catch the earliest signs of dementia. Stern tracked yearly changes in 156 who developed Alzheimer's, and found that those who had a history of diabetes and high cholesterol worsened faster, he reports this month in a special issue of Archives of Neurology dedicated to the link.
Type 2 diabetes occurs as a result of insulin resistance, as the body gradually loses sensitivity to this hormone that's essential for turning blood sugar into energy. A similar effect in the brain helps explain the dementia link, Dr. Suzanne Craft of the Veterans Affairs Puget Sound Health Care System concludes in a research review also published in that journal. Insulin influences memory in a variety of ways, and an insulin-resistant body in turn affects brain cells' insulin-related activity.
Other factors -- such as brain inflammation and cell-damaging oxidative stress -- may play a role, too. But clearly more affected is a silent dysfunction of glucose control, not something that suddenly begins after diabetes is diagnosed.
"You want to think of it more as a continuum than just whether or not you have diabetes," Stern says.
While scientists sort out exactly what's going on, the research does point to some common-sense protections: If you have diabetes, closely follow your doctor's advice for controlling it. Try to lower high cholesterol and blood pressure that can harm the brain's blood supply and exacerbate memory problems.
And if you're still healthy, Nixon advises "hedging your bets against Alzheimer's" with the same steps that help prevent both diabetes and heart disease -- a good diet and plenty of exercise.
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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