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Chapter 8 - Cognitive Impairment and Endocrine Conditions

Published online by Cambridge University Press:  14 October 2021

By
Anne M. Doherty  and
Seán F. Dinneen
Edited by
Anne M. Doherty ,
Aoife M. Egan  and
Sean Dinneen
Anne M. Doherty
Affiliation:
University College Dublin
Aoife M. Egan
Affiliation:
Division of Endocrinology and Metabolism, Mayo Clinic, Minnesota, USA
Sean Dinneen
Affiliation:
School of Medicine, National University of Ireland, Galway
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Summary

Cognitive impairment or dementia is increasing in prevalence worldwide and may be an unrecognised and early complication of a number of endocrine conditions, including diabetes mellitus and thyroid disease. In addition, these conditions may be predisposing factors towards developing dementia. In this chapter, we will discuss these issues with reference to diabetes in particular, being the endocrine disorder with the strongest association with cognitive impairment. Identifying cognitive impairments among people with endocrine disorders is important, as is identifying endocrine conditions in people living with dementia, as this may require adjustment of therapeutic targets and of treatment. There are particular challenges in certain clinical groups, including depressive pseudodementia, behavioural and psychological symptoms of dementia, frailty and mild cognitive impairment. Targets for glycaemic control may need to be relaxed in this group of patients, and this is supported by international best practice guidelines.

Keywords

dementiaendocrinologydiabetesmental healthmild cognitive impairment
Type
Chapter
Information
Mental Health, Diabetes and Endocrinology , pp. 81 - 94
Publisher: Cambridge University Press
Print publication year: 2021

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References

Alzheimer’s Disease International. World Alzheimer’s Report 2015: The Global Impact of Dementia. Alzheimer’s Disease International, 2015.Google Scholar
Gale, SA, Acar, D, Daffner, KR. Dementia. Am J Med. 2018; 131(10): 1161–9.Google Scholar
Chatterjee, S, Peters, SA, Woodward, M, Mejia Arango, S, Batty, GD, Beckett, N, et al. Type 2 diabetes as a risk factor for dementia in women compared with men: a pooled analysis of 2.3 million people comprising more than 100,000 cases of dementia. Diabetes Care. 2016; 39(2): 300–7.Google Scholar
Fagot-Campagna, A, Bourdel-Marchasson, I, Simon, D. Burden of diabetes in an aging population: prevalence, incidence, mortality, characteristics and quality of care. Diabetes Metab. 2005; 31(Spec. No. 2): 5s35–52.Google Scholar
Aspray, TJ, Nesbit, K, Cassidy, TP, Farrow, E, Hawthorne, G. Diabetes in British nursing and residential homes: a pragmatic screening study. Diabetes Care. 2006; 29(3): 707–8.CrossRefGoogle Scholar
Chandran, SR, Jacob, P, Choudhary, P. A systematic review of the effect of prior hypoglycaemia on cognitive function in type 1 diabetes. Ther Adv Endocrinol Metab. 2020; 11: 2042018820906017.Google Scholar
Tomlin, A, Sinclair, A. The influence of cognition on self-management of type 2 diabetes in older people. Psychol Res Behav Manag. 2016; 9: 7–20.Google ScholarPubMed
Sinclair, AJ, Hillson, R, Bayer, AJ. Diabetes and dementia in older people: a Best Clinical Practice Statement by a multidisciplinary National Expert Working Group. Diabet Med. 2014; 31(9): 1024–31.CrossRefGoogle Scholar
Bunn, F, Goodman, C, Malone, JR, Jones, PR, Burton, C, Rait, G, et al. Managing diabetes in people with dementia: protocol for a realist review. Syst Rev. 2016; 5: 5.Google Scholar
Salutini, E, Bianchi, C, Santini, M, Dardano, A, Daniele, G, Penno, G, et al. Access to emergency room for hypoglycaemia in people with diabetes. Diabetes Metab Res Rev. 2015; 31(7): 745–51.CrossRefGoogle ScholarPubMed
JBDS, RCPsych. The Management of Diabetes in Adults and Children with Psychiatric Disorders in Inpatient Settings. Joint British Diabetes Societies and Royal College of Psychiatrists, 2017.Google Scholar
Dubois, B, Feldman, HH, Jacova, C, Cummings, JL, Dekosky, ST, Barberger-Gateau, P, et al. Revising the definition of Alzheimer’s disease: a new lexicon. Lancet Neurol. 2010; 9(11): 1118–27.Google Scholar
Roberts, R, Knopman, DS. Classification and epidemiology of MCI. Clin Geriatr Med. 2013; 29(4): 753–72.Google Scholar
Devenney, KE, Guinan, EM, Kelly, AM, Mota, BC, Walsh, C, Olde Rikkert, M, et al. Acute high-intensity aerobic exercise affects brain-derived neurotrophic factor in mild cognitive impairment: a randomised controlled study. BMJ Open Sport Exerc Med. 2019; 5(1): e000499.Google Scholar
Langa, KM, Levine, DA. The diagnosis and management of mild cognitive impairment: a clinical review. JAMA. 2014; 312(23): 2551–61.CrossRefGoogle ScholarPubMed
Petersen, RC, Lopez, O, Armstrong, MJ, Getchius, TSD, Ganguli, M, Gloss, D, et al. Practice guideline update summary: mild cognitive impairment: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2018; 90(3): 126–35.CrossRefGoogle Scholar
Mistry, N, Wass, J, Turner, MR. When to consider thyroid dysfunction in the neurology clinic. Pract Neurol. 2009; 9(3): 145–56.Google Scholar
Alzoubi, KH, Gerges, NZ, Aleisa, AM, Alkadhi, KA. Levothyroxin restores hypothyroidism-induced impairment of hippocampus-dependent learning and memory: behavioral, electrophysiological, and molecular studies. Hippocampus. 2009; 19(1): 66–78.Google Scholar
Vara, H, Martinez, B, Santos, A, Colino, A. Thyroid hormone regulates neurotransmitter release in neonatal rat hippocampus. Neuroscience. 2002; 110(1): 19–28.Google Scholar
Kapoor, R, van Hogerlinden, M, Wallis, K, Ghosh, H, Nordstrom, K, Vennstrom, B, et al. Unliganded thyroid hormone receptor alpha1 impairs adult hippocampal neurogenesis. FASEB J. 2010; 24(12): 4793–805.Google Scholar
Shors, TJ, Townsend, DA, Zhao, M, Kozorovitskiy, Y, Gould, E. Neurogenesis may relate to some but not all types of hippocampal-dependent learning. Hippocampus. 2002; 12(5): 578–84.Google Scholar
Leach, PT, Gould, TJ. Thyroid hormone signaling: contribution to neural function, cognition, and relationship to nicotine. Neurosci Biobehav Rev. 2015; 57: 252–63.CrossRefGoogle ScholarPubMed
Montagna, G, Imperiali, M, Agazzi, P, D’Aurizio, F, Tozzoli, R, Feldt-Rasmussen, U, et al. Hashimoto’s encephalopathy: a rare proteiform disorder. Autoimmun Rev. 2016; 15(5): 466–76.Google Scholar
Lourida, I, Thompson-Coon, J, Dickens, CM, Soni, M, Kuźma, E, Kos, K, et al. Parathyroid hormone, cognitive function and dementia: a systematic review. PLoS ONE. 2015; 10(5): e0127574.Google Scholar
NICE. Dementia: Assessment, Management and Support for People Living with Dementia and Their Carers (NICE Guideline NG97). National Institute for Health and Care Excellence, 2018.Google Scholar
Stern, Y. Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol. 2012; 11(11): 1006–12.Google Scholar
Green, AR, Reifler, LM, Boyd, CM, Weffald, LA, Bayliss, EA. Medication profiles of patients with cognitive impairment and high anticholinergic burden. Drugs Aging. 2018; 35(3): 223–32.Google Scholar
Tannenbaum, C, Paquette, A, Hilmer, S, Holroyd-Leduc, J, Carnahan, R. A systematic review of amnestic and non-amnestic mild cognitive impairment induced by anticholinergic, antihistamine, GABAergic and opioid drugs. Drugs Aging. 2012; 29(8): 639–58.Google ScholarPubMed
Kang, JM, Cho, YS, Park, S, Lee, BH, Sohn, BK, Choi, CH, et al. Montreal Cognitive Assessment reflects cognitive reserve. BMC Geriatr. 2018; 18(1): 261.Google Scholar
Velayudhan, L, Ryu, SH, Raczek, M, Philpot, M, Lindesay, J, Critchfield, M, et al. Review of brief cognitive tests for patients with suspected dementia. Int Psychogeriatr. 2014; 26(8): 1247–62.Google Scholar
Luis, CA, Keegan, AP, Mullan, M. Cross validation of the Montreal Cognitive Assessment in community dwelling older adults residing in the southeastern US. Int J Geriatr Psychiatry. 2009; 24(2): 197–201.Google Scholar
Ruan, Q, D’Onofrio, G, Sancarlo, D, Bao, Z, Greco, A, Yu, Z. Potential neuroimaging biomarkers of pathologic brain changes in mild cognitive impairment and Alzheimer’s disease: a systematic review. BMC Geriatr. 2016; 16: 104.Google Scholar
Fick, DM, Agostini, JV, Inouye, SK. Delirium superimposed on dementia: a systematic review. J Am Geriatr Soc. 2002; 50(10): 1723–32.Google Scholar
Krewulak, KD, Stelfox, HT, Ely, EW, Fiest, KM. Risk factors and outcomes among delirium subtypes in adult ICUs: a systematic review. J Crit Care. 2020; 56: 257–64.Google Scholar
Witlox, J, Eurelings, LS, de Jonghe, JF, Kalisvaart, KJ, Eikelenboom, P, van Gool, WA. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA. 2010; 304(4): 443–51.CrossRefGoogle ScholarPubMed
da Silva Novaretti, TM, D’Avila Freitas, MI, Mansur, LL, Nitrini, R, Radanovic, M. Comparison of language impairment in late-onset depression and Alzheimer’s disease. Acta Neuropsychiatr. 2011; 23(2): 62–8.Google Scholar
Perini, G, Cotta Ramusino, M, Sinforiani, E, Bernini, S, Petrachi, R, Costa, A. Cognitive impairment in depression: recent advances and novel treatments. Neuropsychiatr Dis Treat. 2019; 15: 1249–58.Google Scholar
Conradi, HJ, Ormel, J, de Jonge, P. Presence of individual (residual) symptoms during depressive episodes and periods of remission: a 3-year prospective study. Psychol Med. 2011; 41(6): 1165–74.Google Scholar
Diniz, BS, Butters, MA, Albert, SM, Dew, MA, Reynolds, CF, 3rd. Late-life depression and risk of vascular dementia and Alzheimer’s disease: systematic review and meta-analysis of community-based cohort studies. Br J Psychiatry. 2013; 202(5): 329–35.Google Scholar
Saez-Fonseca, JA, Lee, L, Walker, Z. Long-term outcome of depressive pseudodementia in the elderly. J Affect Disord. 2007; 101(1–3): 123–9.CrossRefGoogle ScholarPubMed
McAllister, TW, Price, TR. Severe depressive pseudodementia with and without dementia. Am J Psychiatry. 1982; 139(5): 626–9.Google Scholar
Theou, O, Sluggett, JK, Bell, JS, Lalic, S, Cooper, T, Robson, L, et al. Frailty, hospitalization, and mortality in residential aged care. J Gerontol A Biol Sci Med Sci. 2018; 73(8): 1090–6.Google Scholar
Fried, LP, Tangen, CM, Walston, J, Newman, AB, Hirsch, C, Gottdiener, J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001; 56(3): M146–56.CrossRefGoogle ScholarPubMed
Rockwood, K. Conceptual models of frailty: accumulation of deficits. Can J Cardiol. 2016; 32(9): 1046–50.Google Scholar
JBDS. Inpatient Care of the Frail Older Adult with Diabetes. Joint British Diabetes Societies, 2019.Google Scholar
Abraha, I, Rimland, JM, Trotta, FM, Dell’Aquila, G, Cruz-Jentoft, A, Petrovic, M, et al. Systematic review of systematic reviews of non-pharmacological interventions to treat behavioural disturbances in older patients with dementia. The SENATOR-OnTop series. BMJ Open. 2017; 7(3): e012759.Google Scholar
Ryu, SH, Katona, C, Rive, B, Livingston, G. Persistence of and changes in neuropsychiatric symptoms in Alzheimer disease over 6 months: the LASER-AD study. Am J Geriatr Psychiatry. 2005; 13(11): 976–83.Google Scholar
Meeks, TW, Jeste, DV. Beyond the black box: what is the role for antipsychotics in dementia? Curr Psychiatr. 2008; 7(6): 50–65.Google ScholarPubMed
Yunusa, I, Alsumali, A, Garba, AE, Regestein, QR, Eguale, T. Assessment of reported comparative effectiveness and safety of atypical antipsychotics in the treatment of behavioral and psychological symptoms of dementia: a network meta-analysis. JAMA Netw Open. 2019; 2(3): e190828.CrossRefGoogle ScholarPubMed
Hamdy, RC, Kinser, A, Dickerson, K, Kendall-Wilson, T, Depelteau, A, Whalen, K. Fronto-temporal dementia, diabetes mellitus and excessive eating. Gerontol Geriatr Med. 2018; 4: 2333721418777057.Google ScholarPubMed
Rascovsky, K, Hodges, JR, Knopman, D, Mendez, MF, Kramer, JH, Neuhaus, J, et al. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain. 2011; 134(Pt 9): 2456–77.CrossRefGoogle ScholarPubMed
Hillson, R. Diabetes Care: A Practical Manual. Oxford University Press, 2008.Google Scholar
Bruce, DG, Davis, WA, Casey, GP, Clarnette, RM, Brown, SG, Jacobs, IG, et al. Severe hypoglycaemia and cognitive impairment in older patients with diabetes: the Fremantle Diabetes Study. Diabetologia. 2009; 52(9): 1808–15.Google Scholar
Vestergaard, P, Rejnmark, L, Mosekilde, L. Increased mortality in patients with a hip fracture – effect of pre-morbid conditions and post-fracture complications. Osteoporos Int. 2007; 18(12): 1583–93.Google Scholar
Alexiou, KI, Roushias, A, Varitimidis, SE, Malizos, KN. Quality of life and psychological consequences in elderly patients after a hip fracture: a review. Clin Interv Aging. 2018; 13: 143–50.Google Scholar
Longo, M, Bellastella, G, Maiorino, MI, Meier, JJ, Esposito, K, Giugliano, D. Diabetes and aging: from treatment goals to pharmacologic therapy. Front Endocrinol (Lausanne). 2019; 10: 45.Google Scholar
American Diabetes Association. 6. Glycemic targets: standards of medical care in diabetes – 2020. Diabetes Care. 2020; 43(Suppl. 1): S66–76.Google Scholar
Sinclair, A, Dunning, T, Colagiuri, S. IDF Global Guidelines for Managing Older People with Type 2 Diabetes. International Diabetes Federation, 2019.Google Scholar

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