Is diabetes associated with increased pathological burden in Alzheimer's disease?

Kaviyon Sadrolashrafi, Suzanne Craft, Boris DeCourt, Abdu Adem, Jeffrey R. Wilson, Justin Miller, Marwan N. Sabbagh

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: We examined the association between Alzheimer's disease (AD) and type 2 diabetes mellitus (DM) and hypothesized that diabetes is associated with an increased pathological burden in clinically and pathologically diagnosed AD. Methods: All data were obtained from the Uniform Data Set (UDS) v3, the Neuropathology Data Set, and the Researcher's Data Dictionary-Genetic Data from the National Alzheimer's Coordinating Center. The dataset (37 cases with diabetes and 1158 cases without) relies on autopsy-confirmed data in clinically diagnosed AD patients who were assessed for diabetes type in form A5 or D2 during at least one visit. Differences in scores were explored using a general linear model. Effect sizes were calculated using sample means and standard deviations (Cohen's d). Results: The presence of diabetes was associated with a lower Thal phase of amyloid plaques (A score; 4.6 ± 0.79 vs. 4.3 ± 0.85, P <.05) and lower Braak stage for neurofibrillary degeneration (B score; 5.58 ± 0.72 vs. 5.16 ± 0.96, P < 0.05) but not for density of neocortical neuritic plaques (CERAD score-C score). The National Institute on Aging–Alzheimer's Association Alzheimer's disease neuropathologic change (ABC score) was not different between AD+DM and AD-DM. Discussion: This pilot study found a significantly lower Thal phase of amyloid plaques and Braak stage for neurofibrillary degeneration in AD-confirmed individuals with diabetes compared to those without. Thus type 2 DM is not associated with increased AD pathology in clinically and pathologically confirmed cases of AD.

Original languageEnglish (US)
Article numbere12248
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume13
Issue number1
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • Alzheimer's disease
  • Alzheimer's disease neuropathologic change (ABC score)
  • Braak neurofibrillary stage (B score)
  • neuritic plaque score (C score)
  • Thal phase (A score)
  • type 2 diabetes mellitus

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health

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