Diabetes-Alzheimer’s Link

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A Barrow Neurological Institute researcher says diabetes may be contributing to the increasing numbers of Americans suffering from Alzheimer’s disease and other forms of dementia. Elliott Mufson, director of the Alzheimer’s Disease Research Laboratory at Barrow, will discuss his warning.

TED SIMONS: Coming up next on "Arizona Horizon," we'll hear about a possible link between diabetes and Alzheimer's disease.

And the authors of a new book on water resources discuss water's non-economic value. Those stories next on "Arizona Horizon."

VIDEO: "Arizona Horizon" is made possible by contributions from the Friends of Eight, members of your Arizona PBS station. Thank you.

TED SIMONS: Good evening and welcome to "Arizona Horizon." I'm Ted Simons. Lawyers for the Arizona Coyotes say they're at work on a $200 million lawsuit against the city of Glendale. This comes after the Glendale city council last night voted to terminate a 15-year agreement with the hockey team. The city claims that the Coyotes violated a conflict of interest law when the team hired a Glendale city attorney not long after the deal was negotiated. The Coyotes claim no law was broken and that Glendale's actions are a quote "blatant attempt to renege on a valid contract." We will have much more on this story tomorrow night on the Journalists' Roundtable.

TED SIMONS: Well, diabetes could well be a major factor in the increasing number of Americans suffering from Alzheimer's disease and other forms of dementia. That's according to our guest, Elliott Mufson, director of the Alzheimer's Disease Research Laboratory at Barrow's Neurological Institute. Good to have you here. Thanks for joining us.

ELLIOTT MUFSON: Thank you for having me.

TED SIMONS: Diabetes, linked with Alzheimer's and dementia? Explain, please.

ELLIOTT MUFSON: Diabetes has two forms. One is juvenile diabetes and the other is adult onset diabetes and they both affect the body's ability to process sugar, which is a fuel which cells need to function properly throughout the body, including the brain. So when you have problems with manufacturing or digesting glucose or sugar in the body, it affects the function of the cells and the cells particularly in the brain which are responsible for memory and things of that nature, get dysfunctional and therefore, you can run into memory problems like you see in Alzheimer's disease.

TED SIMONS: Now is there a connection with type two diabetes, type one diabetes, both?

ELLIOTT MUFSON: No, the biggest connection is between type two diabetes and Alzheimer's disease. Certain studies have suggested you're twice as likely perhaps to get Alzheimer's disease if you have type two diabetes, which is called adult onset diabetes, and it's due to an insulin resistance in the cells to glucose consumption. So over time, and I think there's like 27 million folks who have diabetes over the age of 65 and there's a strong probability that those people may be more at risk for developing Alzheimer's disease than with a person who's not type two diabetic.

TED SIMONS: So the impact of blood sugar and blood sugar levels on the brain. What can you tell us about that?

ELLIOTT MUFSON: Well, if the fuel that you need to keep the cells functioning is not there, then you lead to degeneration. So the brain is composed of a large number of brain cells, all of which interact to form memories. So without the appropriate amount of fuel, which is the glucose or the sugar, then it leads to memory deficits, probably because you have problems in the vasculature as well as cellular degeneration in the brain. It's like taking all the gas out of your car and trying to run the car. You can't do it, because there's no fuel. So if you don't have the fuel to energize your brain cells, you will eventually have memory problems.

TED SIMONS: Is that because of inflammation? What's happening up there?

ELLIOTT MUFSON: You know, it's not really clear what the process is. It may be that the insulin and activity involved in the uptake of glucose is dysfunctional because if you think about insulin and sugar maybe like a lock and key situation, so they don't interact properly and then the cell doesn't take in the appropriate amount of fuel that it needs, and over time, as I said, you could develop dementia.

TED SIMONS: One study shows high blood sugar levels lead to a presence of a protein, this amyloid beta protein.

ELLIOTT MUFSON: Alzheimer's disease is characterized by the deposition of amyloid protein and they form these deposits in the brains of people with Alzheimer's disease. You see it in other diseases and also literature seems to indicate that insulin can play a role in the deposition of that protein and that protein builds up in the brains of people with Alzheimer's disease over time, and then that contributes to the cognitive problems that people with Alzheimer's disease show.

TED SIMONS: And another study shows that middle-aged type one diabetics, middle age type ones, more brain lesions leads to slower cognitive functions, so type one is affected as well?

ELLIOTT MUFSON: Yeah, it is. It's not -- apparently, you can have an interaction with type one, but the major emphasis has been on type two diabetes, which is a later onset type of diabetes.

TED SIMONS: One more study, women without diabetes, two times as likely to have a good cognitive function as those with diabetes. I mean, this is -- this is pretty serious and substantial stuff here. How revolutionary is this in Alzheimer's research?

ELLIOTT MUFSON: Well, it's interesting. The interaction between diabetes and Alzheimer's disease is not new. It has been known or thought to be the case for at least 10 or 15 years but it's received sort of an upsurge of interest. There's been several articles published about the relationship between it. I believe the nih, national institutes of health, has an ongoing clinical trial, trying to see if insulin can alleviate some of the symptoms associated with Alzheimer's disease.

TED SIMONS: Interesting.


TED SIMONS: So is it too much to say that Alzheimer's could be a type three diabetes?

ELLIOTT MUFSON: You know, they use that phrase. I wouldn't go that far because I don't think we know enough about it yet but because a lot of people who have type two diabetes won't get Alzheimer's disease, it's not everybody, it's just -- it's a risk factor, like cardiovascular disease, you know, if you don't exercise, you don't eat properly, those are risk factors for having a heart attack. But it doesn't mean you're going to get a heart attack. So it's too early, in my opinion, to make that jump.

TED SIMONS: Well, this early, though, I guess we have to go in this direction. Are you finding that Alzheimer's research is moving more in this direction?

ELLIOTT MUFSON: Alzheimer's research today is primarily focused on the beta amyloid that we talked about before. It needs to expand its horizons, so to speak, into other areas and the insulin and glucose question is an interesting area to go in. I would like to see more research money put into that. We try to expand things at the neurological institute where I work. We're interested in understanding why nerve cells die and one of the things we look at is how, you know, glucose affects cell survival in the brains of people with Alzheimer's disease.

TED SIMONS: As far as Alzheimer's, I don't want to get far away from diabetes. One in 11 Americans have diabetes. One in three have prediabetes. And the numbers for Alzheimer's are increasing, there's no doubt about that correct?

ELLIOTT MUFSON: Yes. Right now, there's approximately 5.4 million people with Alzheimer's disease. That's just in this country alone and they predict by 2050, it will be up to 15 million people. And like you were saying, huge amount of people with type two diabetes, so you can think that if you have 5.4 million people, 15 million people and you start adding on the effects of diabetic-related brain dysfunction, that's going to be a huge burden on society.

TED SIMONS: Yes, it is. The age for adult onset for Alzheimer's, is that lowering?

ELLIOTT MUFSON: It's not lowering. I mean, I don't know what you mean by lowering. It's probably about 65 or 70.

TED SIMONS: So that's staying the same?

ELLIOTT MUFSON: It's pretty much the same. The difference, you can begin to show some signs of Alzheimer's earlier, where you have what they call model cognitive impairment.

TED SIMONS: With that in mind, is there any study being done, research being done to show those that have the early signs, the early signals, putting them on perhaps a non-carb, no sugar diet, these sorts of things? Anything going there?

ELLIOTT MUFSON: You know, the physicians suggest those things to the patients. As I said before, there is -- there are some clinical trials trying to get insulin into the brain to promote the cells to take up more glucose. But I don't know of any that have really, you know, shown any promise yet. The one trial I did mention is not due to have results until 2017 so we still have to go. But overall in society it's a big problem, and it's going to get worse if we don't hurry up and find some sort of treatment for it.

TED SIMONS: Well, all right it's good to have you here, great information, thanks for joining us.

ELLIOTT MUFSON: Thank you, it's a pleasure. ¶¶ ¶¶ ¶¶ ¶¶ ¶¶ ¶¶ ¶¶ ¶¶ ¶¶ ¶¶

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Elliott Mufson:Director of Alzheimer's Disease Research Laboratory at Barrow

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