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Managing diet, metabolic syndrome may decrease conversion of mild cognitive impairment to dementia

A systematic review of risk factors for developing dementia after mild cognitive impairment found that factors like managing diabetes, prediabetes and neuropsychiatric symptoms may help modify the risk for developing dementia.

“The findings of this systematic review suggest that managing diabetes and components of the metabolic syndrome and dietary interventions are logical targets for future trials,” Claudia Cooper, PhD, MRCPsych, of the division of psychiatry, University College of London and the department of psychiatry and behavioral sciences, Johns Hopkins Bayview Medical Center, Baltimore, and colleagues wrote in the study.

The researchers evaluated 76 epidemiological and clinical studies. They found that in 10 studies of patients with insulin-dependent or non–insulin-dependent diabetes, the unadjusted pooled OR for developing dementia after mild cognitive impairment was 1.65 (95% CI, 1.12-2.43).

In 13 higher quality epidemiological and 18 clinical studies, the researchers found patients with amnestic mild cognitive impairment and diabetes were at an increased risk of developing Alzheimer’s. Specifically, they found diabetes was a risk factor for developing dementia from any-type and amnestic mild cognitive impairment (pooled OR = 1.65; 95% CI, 1.12 to 2.43).

In an epidemiological study, the researchers found that treating diabetes lowered the risk factor for developing dementia, while a clinical study showed patients with diabetes or prediabetes with a fasting glucose of greater than 100 mg/dL with any-type mild cognitive impairment had a higher risk of developing Alzheimer’s dementia. Metabolic syndrome and prediabetes were predictive factors of developing Alzheimer’s dementia for patients with mild cognitive impairment in one study. A single, higher quality epidemiological study showed a Mediterranean diet was associated with a decreased risk of developing Alzheimer’s dementia.

In addition, neuropsychiatric symptoms were significantly associated with developing all-cause dementia or Alzheimer’s dementia in four clinical studies (pooled OR = 3.11, 95% CI, 1.38-7.02). Depression was a predictor of all-cause dementia developing from any-type mild cognitive impairment in epidemiological, but not clinical studies, while higher serum folate levels were a predictor in one epidemiological and one clinical study. – by Jeffrey Craven

Disclosure: Lyketsos reports receiving grant support from NIMH, the National Institute on Aging, Associated Jewish Federation of Baltimore, Weinberg Foundation, Forest, GlaxoSmithKline, Eisai, Pfizer, AstraZeneca, Lilly, Ortho-McNeil, Bristol-Myers Squibb, Novartis, National Football League, Elan and Functional Neuromodulation. Please the full study for a list of all other authors’ relevant financial disclosures.