[Preventive strategy for cognitive decline in elderly with diabetes mellitus]

Abstract

Diabetes increases the risk of cognitive decline including vascular dementia and Alzheimer's disease. Preventive strategy for cognitive impairment is thus needed in elderly with diabetes. To avoid brain injury in diabetic elderly patients, management of hypoglycemia, hyperglycemia, fluctuation of blood glucose, insulin resistance, and cerebral vessel disease is crucial. Recent clinical trials show hyperglycemia should be controlled with HbA1c of 7.2-7.4% for prevention of newly onset of dementia in the elderly. In contrast, little is known for target glucose levels in diabetic elderly combined with demented disease. Careful insight of hypoglycemia seems more important in the elderly. Now, a variety of pharmacological agents for treatment of diabetes is available and it seems clear that a comprehensive approach will be required in order to achieve healthy brain function.