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      Neuropsychiatric Disease and Treatment (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on all aspects of neuropsychiatric and neurological disorders. Sign up for email alerts here.

      63,741 Monthly downloads/views I 2.989 Impact Factor I 4.5 CiteScore I 1.09 Source Normalized Impact per Paper (SNIP) I 0.744 Scimago Journal & Country Rank (SJR)

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      The Effect of Type 2 Diabetes Mellitus on Neuropsychological Symptoms in Chinese Early Alzheimer’s Disease Population

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          Abstract

          Objective

          To explore the effect of Type 2 diabetes mellitus (T2DM) on the development of neuropsychiatric symptoms (NPS) in early Alzheimer’s disease (AD).

          Methods

          From September 2017 to March 2019, a cross-sectional study was conducted on the clinical data of 158 early AD patients over 65 years old in the Department of Neurology of Daping Hospital. All early stage of AD patients were divided into early stage of AD with NPS group and early stage of AD without NPS group according to the presence or absence of NPS. Clinical data of age, sex, body mass index (BMI), smoking and alcohol consumption, history of hypertension, hyperlipidemia, white matter leisure (WML) and T2DM, MMSE, CDR and NPI-Q scores were collected. Multivariate logistic regression analyses were performed to examine the relationship between T2DM and NPS in early AD.

          Results

          Compared with the early stage of AD group without NPS, the early stage of AD group with NPS was older, the proportion of women was higher, the proportion of T2DM, hypertension, hyperlipidemia and WML was higher, and the MMSE score was lower (P< 0.05). T2DM was an independent risk factor for NPS in early stage of AD patients (OR 3.48, 95% CI 2.91–3.84). The incidence of T2DM in AD patients with depression, anxiety, nighttime behavioral disturbances, and appetite disturbances was significantly higher than in AD patients without these symptoms. T2DM was an independent risk factor of depression (OR 2.04, 95% CI 1.71–2.38), anxiety (OR 1.69, 95% CI 1.38–1.97), nighttime behavioral disturbances (OR 1.95, 95% CI 1.75–2.13) and appetite disturbances (OR 1.62, 95% CI 1.33–1.94) in early AD patients.

          Conclusion

          T2DM was an important independent risk factor for NPS in early AD, which promotes the occurrence of depression, anxiety, nighttime behavioral disturbances and appetite disturbances in early AD.

          Most cited references27

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          Depression and hypothalamic-pituitary-adrenal activation: a quantitative summary of four decades of research.

          Cinnamon Stetler, Gregory E. Miller (2024)
          To summarize quantitatively the literature comparing hypothalamic-pituitary-adrenal (HPA) axis function between depressed and nondepressed individuals and to describe the important sources of variability in this literature. These sources include methodological differences between studies, as well as demographic or clinical differences between depressed samples.
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            Common variant in MTNR1B associated with increased risk of type 2 diabetes and impaired early insulin secretion.

            Valeriya Lyssenko, Cecilia L F Nagorny, Michael R Erdos … (2009)
            Genome-wide association studies have shown that variation in MTNR1B (melatonin receptor 1B) is associated with insulin and glucose concentrations. Here we show that the risk genotype of this SNP predicts future type 2 diabetes (T2D) in two large prospective studies. Specifically, the risk genotype was associated with impairment of early insulin response to both oral and intravenous glucose and with faster deterioration of insulin secretion over time. We also show that the MTNR1B mRNA is expressed in human islets, and immunocytochemistry confirms that it is primarily localized in beta cells in islets. Nondiabetic individuals carrying the risk allele and individuals with T2D showed increased expression of the receptor in islets. Insulin release from clonal beta cells in response to glucose was inhibited in the presence of melatonin. These data suggest that the circulating hormone melatonin, which is predominantly released from the pineal gland in the brain, is involved in the pathogenesis of T2D. Given the increased expression of MTNR1B in individuals at risk of T2D, the pathogenic effects are likely exerted via a direct inhibitory effect on beta cells. In view of these results, blocking the melatonin ligand-receptor system could be a therapeutic avenue in T2D.
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              Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population.

              , Carol Brayne, Julia Zaccai … (2009)
              Behavioural and psychological symptoms of dementia (BPSD) are major contributors to the burden of dementia. To describe the prevalence, correlates and course of BPSD in the population of England and Wales. The prevalence of 12 symptoms was estimated in 587 participants with dementia and 2050 participants without dementia as part of a population-based longitudinal study of ageing. The effect of risk factors and the factor structure were estimated using 1782 interviews provided by participants with dementia throughout the study. Each symptom apart from sleeping problems was more common in the population with dementia. The co-occurrence of the symptoms was explained by a four-factor solution, corresponding to psychosis/apathy, depression/anxiety, irritability/persecution and wandering/sleep problems. Psychosis occurred more frequently with declining cognition. Anxiety and depression were more common in younger individuals and in those with poor self-reported health. Persistence varied between symptoms. Behavioural and psychological symptoms of dementia affect nearly all people with dementia. Symptoms co-occur, and the symptoms that affected individuals experience are related to their socio-demographic and clinical characteristics.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Neuropsychiatr Dis Treat
                Journal ID (iso-abbrev): Neuropsychiatr Dis Treat
                Journal ID (publisher-id): NDT
                Journal ID (pmc): neurodist
                Title: Neuropsychiatric Disease and Treatment
                Publisher: Dove
                ISSN (Print): 1176-6328
                ISSN (Electronic): 1178-2021
                Publication date (Electronic): 26 March 2020
                Publication date Collection: 2020
                Volume: 16
                Pages: 829-836
                Affiliations
                [1 ]Department of Neurology, Daping Hospital, Army Medical University , Chongqing 400042, People’s Republic of China
                Author notes
                Correspondence: Huiyun Li Department of Neurology, Daping Hospital, Army Medical University , Chongqing400042, People’s Republic of ChinaTel +86 23 68757851Fax +86 23 68711956 Email lihuiyun1359@163.com
                Author information
                http://orcid.org/0000-0002-7682-5776
                Article
                Publisher ID: 240529
                DOI: 10.2147/NDT.S240529
                PMC ID: 7105356
                SO-VID: 939716cb-2cdd-4883-abe8-0ac3f8ab012a
                Copyright © © 2020 Shi et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 29 November 2019
                Date accepted : 01 March 2020
                Page count
                Figures: 1, Tables: 3, References: 49, Pages: 8
                Funding
                This work was supported by the National Natural Science Foundation of China (81971033). The study funders had no role in the interpretation of the data.
                Categories
                Subject: Original Research

                ScienceOpen disciplines: Neurology
                Keywords: alzheimer’s disease,type 2 diabetes,neuropsychiatric symptoms
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: alzheimer’s disease, type 2 diabetes, neuropsychiatric symptoms

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