According to the American Diabetes Association, 27% of people in the United States age 65 and above have diabetes and about half have prediabetes. Several studies have linked diabetes with lower level of cognitive function. A study published in the New England Journal of Medicine in August 2013 found that people with diabetes face an increased risk of dementia, including Alzheimer’s disease.
However, a new study presented at the Alzheimer’s Association International Conference (AAIC) 2014 held in Copenhagen reports that long-term use of the diabetes drug pioglitazone (Actos) may protect against dementia.
Actos, a class of drugs called thiazolidinediones (TZDs) and an agonist for peroxisome proliferator-activated receptor (PPAR), work by increasing the body’s sensitivity to insulin. Along with showing improvement in blood glucose control, researchers found that thiazolidinediones also has benefits for the brain, particularly with regard to preventing or delaying forms of dementia such as Alzheimer’s disease.
On the assumption that long-term use with pioglitazone would reduce the risk for dementia, researchers from the German Center for Neurodegenerative Diseases reviewed around 146,000 health records of people over 60 years of age who had no previous signs of dementia. It was found that the rates of dementia were noticeably lower in those taking the type 2 diabetes drug pioglitazone (Actos). According to the researchers, one possible explanation is the drug’s ability to contain neuroinflammation.
The researchers calculated the relative risk for dementia with use of pioglitazone, adjusted for sex, age, and use of nonsteroidal anti-inflammatory drugs, rosiglitazone, and metformin, and cardiovascular comorbidities, including diabetes, cerebrovascular disease, hypertension, ischemic heart disease, atrial fibrillation, and hypercholesterolemia. Calculations were done in a Cox proportional hazard model. During follow-up, 13,841 participants developed dementia. With each additional quarter of pioglitazone prescription, the relative risk for dementia fell by 6%.
Neurology rehabilitation and the contribution of physical therapy have undergone significant changes over the years with scientific and technological developments that have enabled better understanding of brain reorganization and the mechanisms of motor control, performance, and impairments.