The Brain Hypometabolism Hypothesis: Part 4 – The Rotterdam Study


In their paper, Cunnane and colleagues look at the evidence for a role of altered brain metabolism in the development of Alzheimer’s Disease.

One of the lines of evidence is that glucose resistance is associated with an increased risk of Alzheimer’s Disease and one study which supports this is the Rotterdam study.

In the Rotterdam study, the cohort was assessed at baseline in 1990. In this paper, the cohort was followed up for an average of 7.2 years. The HOMA (homeostasis model assessment) index was used for the insulin resistance calculation.

The researchers noted that within the first three years of follow-up, doubling the insulin resistance and insulin levels was correlated with a 40% increase in the risk of Alzheimer’s Type Dementia. However this relationship disappeared after 3 years.

There are a few explanations

  1. There is an intermediate period of increased risk as the body adjusts to newly develop insulin resistance
  2. The researchers were looking at Alzheimer’s Type Dementia rather than Alzheimer’s Disease pathology
  3. The findings would benefit from replication. The problem with this is that there were 22, 494 person years of follow-up. On the other hand 211 participants developed Alzheimer’s Type Dementia.

The study found an inverse relationship between higher levels of glucose and risk of Alzheimer’s Type Dementia which is difficult to interpret. Insulin resistance and Diabetes lead to higher levels of glucose. Again this might relate to point 3 above.

So in summary there is some evidence that insulin resistance is linked to a higher risk of Alzheimer’s Type Dementia. On the other hand this relationship disappears after 3 years and there is an inverse relationship identified with glucose levels.

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Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

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