糖尿病と認知症

Diabetes and Dementia

高齢化に伴い糖尿病も認知症も患者数は増加すると予想される。糖尿病は認知症発症を促進するため，糖尿病患者では軽度認知障害の段階で認知機能障害を早期発見することが重要である。MoCA（Montreal Cognitive Assessment）による筆者らの検討では，糖尿病教育入院中の72%の患者に糖尿病合併軽度認知障害が疑われた。糖尿病治療薬によるアルツハイマー病の治療が試みられ，糖尿病はパーキンソン病などの神経変性疾患との関連も指摘されている。

Abstract

An aging global population is driving the current epidemic of dementia and type 2 diabetes mellitus. Diabetes is a known risk factor for the development of vascular dementia, Alzheimer's disease, and mild cognitive impairment. Good control of diabetes may improve cognitive decline and prevent Alzheimer's disease. Mild cognitive impairment with type 2 diabetes (DM-MCI) often presents as a decline in attention, psychomotor speed, executive function, and memory. The Montreal Cognitive Assessment (MoCA) is one of the best screening tools for detecting DM-MCI. We found that 72% of the patients admitted to educational hospitalization for type 2 diabetes could also be categorized into groups with frontal lobe dysfunction, delayed recall, and a mixed-type group. Anti-diabetic drugs and insulin may protect and improve cognitive dysfunction in Alzheimer's disease and DM-MCI, but more studies are needed to verify this claim. Diabetes mellitus may be linked not only to Alzheimer's disease but also to other neurodegenerative diseases, such as Parkinson's, Huntington's and frontotemporal lobe dementia.