[Source: Baoji Health]
Senior diabetics should prevent dementia
China Member of the Diabetes Prevention and Control Professional Committee of the Preventive Medicine Association
Yao Yongli, Qinghai Provincial People’s Hospital
Diabetes is one of the risk factors for increased cognitive dysfunctionOne, diabetes Not only did patients have a higher risk of developing cognitive impairment than non-diabetic patients, but they progressed more rapidly. The elderly are a high-risk group of diabetes. In recent years, with the prolongation of life expectancy of diabetic patients, the complications of diabetes have changed, and Alzheimer’s disease is one of the important problems.
Alzheimer’s disease is also called senile dementia. Most senile dementia patients are caused by lifestyle and environment. It is caused in part by genetic changes. The onset of Alzheimer’s disease is insidious, and the symptoms are progressively aggravated. With the development of the disease, the memory impairment gradually deteriorates, and other symptoms gradually appear. Diabetes is an important factor in the occurrence of cognitive impairment, and cognitive impairment is the only way to develop dementia.
Diabetes and Alzheimer’s disease linked
Are diabetes and Alzheimer’s disease two completely different diseases? no. Several studies have found an association between the two, with type 2 diabetes at twice the risk of developing Alzheimer’s disease compared with non-diabetic subjects, and an increased risk of dementia in subjects with prediabetes. In 14.6% of all-cause dementia cases, accounting for 20.1% of Alzheimer’s disease cases, elevated 2-hour postprandial blood glucose levels were significantly associated with an increased risk of dementia, and the cognitive function of diabetic patients was generally lower than that of non-diabetic patients.
The poor control of blood sugar in elderly patients with diabetes, whether it is hyperglycemia or hypoglycemia, may cause damage to brain tissue, have a significant impact on cognitive function, and Diabetes will accelerate the rate of arteriosclerosis, and the occurrence of cerebrovascular disease will also advance the age of onset of Alzheimer’s disease; while Alzheimer’s disease is a degenerative disease of the central nervous system mainly characterized by memory impairment. The decline of cognitive function in patients is related to their secondary cerebrovascular diseases, including atherosclerosis, cerebral infarction, and small vessel disease. On the other hand, diabetes and Alzheimer’s disease share a strong epidemiological link and the same pathogenic pathways (impaired insulin signaling, presence of low-grade inflammation, accumulation of advanced glycation end products, oxidative stress increase, etc.).
Other studies have shown that acute, severe hypoglycemia episodes can also lead to chronic subclinical brain damage, cognitive decline and subsequent dementia. Some researchers believe that diabetes and Alzheimer’s disease may be the same disease, and some even call Alzheimer’s disease type 3 diabetes or cerebral diabetes. It can be said that these two diseases are closely related.
Recognize risks and improve management
Rational diet, regular physical and mental exercise, good sleep, blood pressure control, prevention and treatment of diabetes, cerebrovascular disease, atrial fibrillation, etc. Prevention is helpful.
The principle of prevention and treatment of Alzheimer’s disease is to identify and control existing risk factors (correct bad habits, control various metabolic abnormalities, and treat induced diseases). Cognitive decline, abnormal brain imaging; cognitive impairment and hypoglycemia interact with each other. Diabetic patients with hypoglycemic events are at higher risk of dementia, and diabetic patients with dementia are more prone to hypoglycemic events.
It is recommended to formulate more relaxed blood glucose management goals, and set individualized goals as relaxed blood glucose goals to avoid hypoglycemia after the onset of Alzheimer’s disease. On the other hand, there is more evidence that improved glycemic control is associated with a lower risk of Alzheimer’s disease.
More and more evidences show that type 2 diabetes drugs have neuroprotective effects, can repair and regenerate damaged nerve cells, and have the potential to change cognitive function. . Cognitive decline was attenuated with metformin, thiazolidinediones, dipeptidyl peptidase 4 inhibitors, and GLP-1 receptor agonists.
Elderly diabetic patients, if their ability to manage their lives on their own is limited, they need to set up “supervisors” (relatives or caregivers). Under the guidance of a doctor, a beneficial sleep, daily life and diet plan is formulated, and corresponding artistic functional training is arranged by professionals for various weakened cognitive functions. These are the treatment modes most needed by Alzheimer’s patients.
Elderly diabetic patients who are prone to depression and anxiety need to be treated by neurological and psychiatrist and supervised by supervisors.
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