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Diabetes is related to cerebral infarction but not to AD pathology in older persons.

Abstract

OBJECTIVE

To examine the potential relation of diabetes to common neuropathologic causes of dementia, cerebral infarction and Alzheimer disease (AD) neuropathology.

METHODS

Subjects were 233 older Catholic clergy in the Religious Orders Study, who underwent detailed annual evaluations, including neuropsychological testing, and brain autopsy at time of death (mean age 86 years, 45% men). Diabetes was identified by annual direct medication inspection and history. Cognitive function proximate to death was summarized into five cognitive domains, based on 19 neuropsychological tests. Macroscopic cerebral infarctions were recorded from 1 cm coronal slabs. Neuritic plaques, diffuse plaques, and neurofibrillary tangles were counted in Bielschowsky silver-stained sections and summarized to yield composite measures of neuritic plaques, diffuse plaques, tangles, and overall AD pathology. We also used immunohistochemistry with antibodies to amyloid-beta and PHF-tau to obtain quantitative measures of amyloid burden and neurofibrillary tangle density. Multiple logistic and linear regression analyses were used to examine the relation of diabetes to cerebral infarctions and AD pathology, controlling for age, sex, and education.

RESULTS

AD pathology was related to all five cognitive domains (p < 0.01) and infarctions were related to perceptual speed (p < 0.001). Diabetes (present in 15% subjects) was associated with an increased odds of infarction (OR = 2.47, 95% CI: 1.16, 5.24). Diabetes was not related to global AD pathology score, or to specific measures of neuritic plaques, diffuse plaques or tangles, or to amyloid burden or tangle density.

CONCLUSION

We found a relation between diabetes and cerebral infarction but not between diabetes and Alzheimer disease pathology in older persons.

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  • Authors+Show Affiliations

    ,

    Rush Alzheimer's Disease Center, 600 S. Paulina, Suite 1020, Rush University Medical Center, Chicago, IL 60612, USA.

    , , , , ,

    Source

    Neurology 67:11 2006 Dec 12 pg 1960-5

    MeSH

    Aged
    Aged, 80 and over
    Alzheimer Disease
    Cerebral Infarction
    Diabetes Complications
    Diabetes Mellitus
    Female
    Humans
    Logistic Models
    Longitudinal Studies
    Male
    Neurofibrillary Tangles
    Plaque, Amyloid
    Risk Factors

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    17159101

    Citation

    Arvanitakis, Z, et al. "Diabetes Is Related to Cerebral Infarction but Not to AD Pathology in Older Persons." Neurology, vol. 67, no. 11, 2006, pp. 1960-5.
    Arvanitakis Z, Schneider JA, Wilson RS, et al. Diabetes is related to cerebral infarction but not to AD pathology in older persons. Neurology. 2006;67(11):1960-5.
    Arvanitakis, Z., Schneider, J. A., Wilson, R. S., Li, Y., Arnold, S. E., Wang, Z., & Bennett, D. A. (2006). Diabetes is related to cerebral infarction but not to AD pathology in older persons. Neurology, 67(11), pp. 1960-5.
    Arvanitakis Z, et al. Diabetes Is Related to Cerebral Infarction but Not to AD Pathology in Older Persons. Neurology. 2006 Dec 12;67(11):1960-5. PubMed PMID: 17159101.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Diabetes is related to cerebral infarction but not to AD pathology in older persons. AU - Arvanitakis,Z, AU - Schneider,J A, AU - Wilson,R S, AU - Li,Y, AU - Arnold,S E, AU - Wang,Z, AU - Bennett,D A, PY - 2006/12/13/pubmed PY - 2007/1/9/medline PY - 2006/12/13/entrez SP - 1960 EP - 5 JF - Neurology JO - Neurology VL - 67 IS - 11 N2 - OBJECTIVE: To examine the potential relation of diabetes to common neuropathologic causes of dementia, cerebral infarction and Alzheimer disease (AD) neuropathology. METHODS: Subjects were 233 older Catholic clergy in the Religious Orders Study, who underwent detailed annual evaluations, including neuropsychological testing, and brain autopsy at time of death (mean age 86 years, 45% men). Diabetes was identified by annual direct medication inspection and history. Cognitive function proximate to death was summarized into five cognitive domains, based on 19 neuropsychological tests. Macroscopic cerebral infarctions were recorded from 1 cm coronal slabs. Neuritic plaques, diffuse plaques, and neurofibrillary tangles were counted in Bielschowsky silver-stained sections and summarized to yield composite measures of neuritic plaques, diffuse plaques, tangles, and overall AD pathology. We also used immunohistochemistry with antibodies to amyloid-beta and PHF-tau to obtain quantitative measures of amyloid burden and neurofibrillary tangle density. Multiple logistic and linear regression analyses were used to examine the relation of diabetes to cerebral infarctions and AD pathology, controlling for age, sex, and education. RESULTS: AD pathology was related to all five cognitive domains (p < 0.01) and infarctions were related to perceptual speed (p < 0.001). Diabetes (present in 15% subjects) was associated with an increased odds of infarction (OR = 2.47, 95% CI: 1.16, 5.24). Diabetes was not related to global AD pathology score, or to specific measures of neuritic plaques, diffuse plaques or tangles, or to amyloid burden or tangle density. CONCLUSION: We found a relation between diabetes and cerebral infarction but not between diabetes and Alzheimer disease pathology in older persons. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/17159101/Diabetes_is_related_to_cerebral_infarction_but_not_to_AD_pathology_in_older_persons_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=17159101 DB - PRIME DP - Unbound Medicine ER -