The Twin Epidemics: Diabetes, Alzheimer's

BFP Magazine

Neurology and Health

Diabetes, Alzheimer's

The Twin Epidemics

By Dr. W. Gifford Jones

November 26, 2006

I experienced a terrible tragedy upon visiting an old friend. He failed to recognize me. All the past history of our years together vanished into the night. And as I drove home the question recurred; what had caused this mental disaster. Could he be victim to what's been called the "Twin Epidemic"? Had his long-standing diabetes played a factor in this condition?

Marilyn Albert, an expert on Alzheimer's Disease at Johns Hopkins University in Baltimore, says that "when it comes to keeping the brain healthy adding extra pounds may be a double-edged sword. That it's not only a risk factor for developing Type 2 diabetes, but also a trigger for Alzheimer's Disease."

Dr Zoe Arvanitakis, a neurologist at Rush University Medical Center in Chicago, shares this opinion. She says, "We are going to see more and more people with Type 2 diabetes and more and more people with Alzheimer's Disease."

But what's the evidence that diabetes could be a factor in the development of Alzheimer's Disease? Is so, what can you do to decrease the risk?

I dislike using statistics to resolve a problem, but you can't ignore today's facts. For instance, today there are 17.5 million people with diabetes in North America and 5.5 million suffering from Alzheimer's Disease. It's estimated that by 2050 the number of diabetes patients will reach 32 million and 18 million will have Alzheimer's Disease. These huge numbers make you wonder if they share a connection.

Researchers in Chicago studied 842 older Catholic nuns, priests and brothers who had diabetes. None had any sign of Alzheimer's Disease at the start, but nine years later 151 had this disease.

Another study published in the Archives of Neurology in 2004 claimed that those with Type 2 diabetes had a 65 percent greater chance of developing Alzheimer's Disease. But how does Type 2 diabetes increase this risk?

Dr Gregory Cole, a researcher at the University of California, says that excess weight causes, not only diabetes, but also insulin resistance in which cells do not respond to the hormone insulin.

Insulin normally transports sugar (glucose) into cells where it's used as energy. But when insulin resistance occurs cells fail to get sufficient sugar. And brain cells starved of sugar may either malfunction or die, setting the stage for Alzheimer's Disease.

Cole says the entire process may be kicked off by too much fat in the diet. In one experiment Cole fed rats a high fat diet causing insulin resistance. This in turn resulted in a build-up of poisonous protein called beta amyloid.

Beta amyloid clumps together damaging brain cells and the connections between them. This is believed to play a major role in memory loss.

We also know that diabetes results in atherosclerosis, a narrowing of arteries which results in a decrease of oxygenated blood to organs. This is why so many diabetics die from heart attack, blindness, kidney failure and gangrene of the legs. Without oxygen we die and brain cells are even more dependant on an adequate supply of oxygen.

Undoubtedly other factors play a role in the development of Alzheimer's Disease. But this research shows what we so often see in medicine, one problem leading to another often bigger one. In this case it's a huge one. A report from the World Health Organization shows that 75 percent of Americans over the age of 50 have insulin resistance. Not surprising, since obesity is so rampant in the U.S. where every meal is super-size.

Since the loss of mental acuity is one of the worst possible scenarios of aging what can you do to try and prevent it? The message is crystal clear. If you're over weight take it seriously and lose pounds. Studies show that even a modest loss of 10 pounds can either improve or prevent insulin resistance.

Build activity into your life by walking, running or biking. Exercise helps insulin to be more efficient.

Concentrate on a low fat diet that contains whole grains, fruits and vegetables and fish. Studies show that fish contains healthy omega-3 fatty acids, a fat that may help to lower the risk of Alzheimer's Disease. And remember you don't know your gaining weight if you don't have a scale!

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of The Harvard Medical School. He's been a ship's surgeon, hotel physician and family doctor and later trained in surgery at McGill in Montreal, University of Rochester N.Y. and Harvard. His medical column is published by 60 Canadian newspapers and several in the U.S. He is the author of seven books. Dr. Walker has a medical practice in Toronto. His Web site is: He can be reached at

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