ArticleArchives of neurology2009
Different patterns of cerebral injury in dementia with or without diabetes.
Article in Archives of neurology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 3 of them syntheses that pooled it.
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Who cites it
102 citing papers in PubMed, 3 syntheses or guidelines pooled it, 221 citations in OpenAlex.
- Cerebral microinfarcts: a systematic review of neuropathological studies.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2012Pooled it
- National Institute on Aging-Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease: a practical approach.Acta neuropathologica · 2012Guideline
- Mild cognitive impairment and dementia: the importance of modifiable risk factors.Deutsches Arzteblatt international · 2011Pooled it
- Long-term Change in Physiological Markers and Cognitive Performance in Type 2 Diabetes: The Look AHEAD Study.The Journal of clinical endocrinology and metabolism · 2020Trial
- Diet intervention and cerebrospinal fluid biomarkers in amnestic mild cognitive impairment.Archives of neurology · 2011Trial
- Diabetic cerebral microvascular disorder: from key pathologies to targeted interventions.Annals of medicine · 2026Review
- Diabetes-Associated Cognitive Impairment: Pathophysiology and Emerging Therapies.Annals of clinical and translational neurology · 2026Review
- Why diabetes matters in dementia studies: Failure to account for diabetes status masks regional mitochondrial DNA copy number changes in human hippocampus, amygdala, and cerebellum in Alzheimer's disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Why diabetes matters in dementia studies: Excluding diabetes status masks regional mitochondrial DNA copy number changes in human hippocampus, amygdala, and cerebellum in Alzheimer's disease.bioRxiv : the preprint server for biology · 2026Article
- Associations of modifiable and non-modifiable risk factors with longitudinal white matter hyperintensities, amyloid-β and tau - a prospective cohort study.The journal of prevention of Alzheimer's disease · 2026Observational
- The influence of diabetic retinopathy on the risk of dementia: A nationwide cohort study.Scientific reports · 2025Article
- Comprehensive Clinical and Behavioral Characteristics of Mild Cognitive Impairment According to Amyloid Positivity: A Large Multi-Center Korean Cohort.Dementia and neurocognitive disorders · 2025Article
- Metformin effectively alleviates the symptoms of Alzheimer in rats by lowering amyloid β deposition and enhancing the insulin signal.Metabolic brain disease · 2024Article
- The Contribution of Type 2 Diabetes to Parkinson's Disease Aetiology.International journal of molecular sciences · 2024Review
- Insights from Turkey's big data: unraveling the preventability, pathogenesis, and risk management of Alzheimer's disease (AD).Scientific reports · 2024Article
- Metformin, age-related cognitive decline, and brain pathology.Neurobiology of aging · 2024Article
- Serum proinsulin levels as peripheral blood biomarkers in patients with cognitive impairment.Scientific reports · 2023Article
- Metformin: The Winding Path from Understanding Its Molecular Mechanisms to Proving Therapeutic Benefits in Neurodegenerative Disorders.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Characterization of hippocampal sclerosis of aging and its association with other neuropathologic changes and cognitive deficits in the oldest-old.Acta neuropathologica · 2023Article
- Potential Role of Glucagon-like Peptide-1 Receptor Agonists in the Treatment of Cognitive Decline and Dementia in Diabetes Mellitus.International journal of molecular sciences · 2023Review
42 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundDiabetes mellitus (DM) increases the risk of dementia in the elderly. However, its underlying mechanisms, its connection with Alzheimer disease and vascular cognitive impairment, and effects of therapy remain unclear.
objectiveTo test the hypothesis that DM promotes specific neuropathologic processes that contribute to dementia and that these processes may be suppressed by antidiabetic therapy.
designA comprehensive neuropathologic assessment of all cases from a community-based study of incident dementia (Adult Changes in Thought Study) that underwent autopsies (n = 259) and had information on DM status (n = 196). Biochemical analysis was conducted on a subset of these cases with rapidly frozen brain tissue (n = 57).
participantsAutopsy cases were divided into 4 groups: no DM/no dementia (DM-/dementia-), DM/no dementia (DM+/dementia-), no DM/dementia (DM-/dementia+), and DM/dementia (DM+/dementia+). Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnosis of dementia was assigned through a consensus of experts following biennial cognitive and physical evaluations. Diabetes was diagnosed based on information obtained from participants' extensive medical records.
resultsIn cases without dementia (n = 125), neuropathologic and biochemical end points did not differ significantly by DM status. However, we observed 2 patterns of injury in patients with dementia (n = 71) by their DM status. Individuals without DM but with dementia (DM-/dementia+) had a greater amyloid-beta peptide load and increased levels of F(2)-isoprostanes in the cerebral cortex, while DM+/dementia+ patients had more microvascular infarcts and an increased cortical IL-6 (interleukin 6) concentration. The number of microvascular infarcts was greater in deep cerebral structures in patients with dementia whose diabetes was treated, whereas amyloid plaque load tended to be greater for untreated diabetic patients with dementia.
conclusionsThese novel characterizations of 2 different patterns of cerebral injury in patients with dementia depending on DM status may have etiologic and therapeutic implications. Published online January 12, 2009 (doi:10.1001/archneurol.2008.579).
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