Alzheimer's disease and type 2 diabetes mellitus are distinct diseases with potential overlapping metabolic dysfunction upstream of observed cognitive decline

Yevgen Chornenkyy, Wang Xia Wang, Angela Wei, Peter T. Nelson

Research output: Contribution to journalReview articlepeer-review

109 Scopus citations

Abstract

Alzheimer's disease (AD) and type 2 diabetes mellitus (T2DM) are highly prevalent aging-related diseases associated with significant morbidity and mortality. Some findings in human and animal models have linked T2DM to AD-type dementia. Despite epidemiological associations between the T2DM and cognitive impairment, the interrelational mechanisms are unclear. The preponderance of evidence in longitudinal studies with autopsy confirmation have indicated that vascular mechanisms, rather than classic AD-type pathologies, underlie the cognitive decline often seen in self-reported T2DM. T2DM is associated with cardiovascular and cerebrovascular disease (CVD), and is associated with increased risk of infarcts and small vessel disease in the brain and other organs. Neuropathological examinations of post-mortem brains demonstrated evidence of cerebrovascular disease and little to no correlation between T2DM and β-amyloid deposits or neurofibrillary tangles. Nevertheless, the mechanisms upstream of early AD-specific pathology remain obscure. In this regard, there may indeed be overlap between the pathologic mechanisms of T2DM/“metabolic syndrome,” and AD. More specifically, cerebral insulin processing, glucose metabolism, mitochondrial function, and/or lipid metabolism could be altered in patients in early AD and directly influence symptomatology and/or neuropathology.

Original languageEnglish
Pages (from-to)3-17
Number of pages15
JournalBrain Pathology
Volume29
Issue number1
DOIs
StatePublished - Jan 2019

Bibliographical note

Publisher Copyright:
© 2018 International Society of Neuropathology

Keywords

  • VCID
  • epidemiology
  • mitochondria
  • neuropathology
  • pathogenesis
  • preclinical

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • General Neuroscience
  • Clinical Neurology

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