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Coexistence of Alzheimer's Disease and Diabetes Mellitus

1992; Wiley; Volume: 40; Issue: 10 Linguagem: Inglês

10.1111/j.1532-5415.1992.tb04492.x

1532-5415

Gary W. Small, Mark J. Rosenthal,

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Journal of the American Geriatrics SocietyVolume 40, Issue 10 p. 1075-1076 Free Access Coexistence of Alzheimer's Disease and Diabetes Mellitus Gary W. Small MD, Gary W. Small MD Department of Psychiatry UCLA School of Medicine Veterans Affairs Medical Center West Los Angeles Los Angeles, CASearch for more papers by this authorMark J. Rosenthal MD, Mark J. Rosenthal MD Geriatric Research Education Clinical Center Veterans Affairs Medical Center Sepulveda Sepulveda, CASearch for more papers by this author Gary W. Small MD, Gary W. Small MD Department of Psychiatry UCLA School of Medicine Veterans Affairs Medical Center West Los Angeles Los Angeles, CASearch for more papers by this authorMark J. Rosenthal MD, Mark J. Rosenthal MD Geriatric Research Education Clinical Center Veterans Affairs Medical Center Sepulveda Sepulveda, CASearch for more papers by this author First published: October 1992 https://doi.org/10.1111/j.1532-5415.1992.tb04492.xCitations: 6AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat To the Editor:—Wolf-Klein and associates1 reported a lower frequency of diabetes mellitus in patients with a clinical diagnosis of Alzheimer's disease (AD), 3.5% for men and 4.2% for women, compared with those with an abnormal mental status attributed to other causes, 13.3% for men and 17.1% for women, and to clinic patients with normal mental status, 16.5% for men and 13.7% for women. They speculated that these results suggest a protective effect of hyperglycemia on the brain, ie, that higher blood glucose concentrations might overcome an impediment to the metabolism or transport of glucose in the aging brain. In order to confirm this intriguing result, we reviewed medical records of 51 patients with autopsy-confirmed AD and 18 nearly age-matched controls. Autopsy results and medical records were available through the National Neurologic Research Specimen Bank. All procedures were approved by the Research and Development Committee, the Human Use Committee, and the Radiation Safety Officer at the Department of Veterans Affairs Medical Center West Los Angeles. All patients met National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria for definite AD.2 Controls had neuropathological exams demonstrating no central nervous system disease and clinical histories showing no evidence of dementing illness. The mean age for the patient group (76.4 ± 6.7 years) was significantly (one-way ANOVA, df = 1,67; F = 12.95; P < 0.001) greater than that for controls (68.0 ± 12.4 years). The proportion of women was greater in the AD group (female/male ratio = 17/20) compared with the control group (female/male ratio = 5/13). The frequency of diabetes mellitus was similar for both groups: three of the 51 AD patients (5.9%) and one of the 18 controls (5.6%) had histories of diabetes mellitus. The frequency for diabetes mellitus in AD patients found in our study (5.9%) was close to that found by Wolf-Klein and co-workers (3.5% to 4.2%). However, the rate of diabetes mellitus was significantly higher in their controls without AD (13.3% to 17.1%). Several methodological issues may explain such differing results. Control groups derived from clinic populations probably provide higher rates of medical illness than those from non-clinic populations. These studies also differed in diagnostic methods. Studies of neuropathologically confirmed AD have found error rates for prior clinical diagnoses to range from 10% to 30%.3, 4 Our study included a relatively small sample size, making it difficult to prove the null hypothesis and compare subgroups of men and women. Moreover, our control group was younger than the patient group, which could partially explain the low frequency of diabetes mellitus among controls. Recognizing such methodological issues, we can say only that our results thus far fail to confirm the observation that diabetes mellitus is less frequent among AD patients. REFERENCES 1 Wolf-Klein GP, Silverstone FA, Brod MS et al. Are Alzheimer patients healthier J Am Geriatr Soc 1988; 36: 219– 224. Wiley Online LibraryCASPubMedWeb of Science®Google Scholar 2 McKhann G, Drachman D, Folstein M et al. Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer's disease. Neurology 1984; 34: 939– 944. CrossrefCASPubMedWeb of Science®Google Scholar 3 Martin EM, Wilson RS, Penn RD et al. Cortical biopsy results in Alzheimer's disease: Correlation with cognitive deficits. Neurology 1987; 37: 1201– 1204. CrossrefCASPubMedWeb of Science®Google Scholar 4 Risse SC, Raskind MA, Nochlin DA et al. Neuropathological findings in patients with clinical diagnoses of probable Alzheimer's disease. Am J Psychiatry 1990; 147: 168– 172. CrossrefCASPubMedWeb of Science®Google Scholar Citing Literature Volume40, Issue10October 1992Pages 1075-1076 ReferencesRelatedInformation