title: [Changes in cognitive function in patients with diabetes mellitus].
abstract: Patients with diabetes are approximately 1.5 times more likely to experience cognitive decline than individuals without diabetes mellitus. Most of the data suggest that patients with diabetes have reduced performance in numerous domains of cognitive function. In patients with type 1 diabetes, specific and global deficits involving speed of psychomotor efficiency, information processing, mental flexibility, attention, and visual perception seem to be present, while in patients with type 2 diabetes an increase in memory deficits, a reduction in psychomotor speed, and reduced frontal lobe (executive) functions have been found. The complex pathophysiology of changes in the central nervous system in diabetes has not yet been fully elucidated. It is important to consider the patient's age at the onset of diabetes, the glycemic control status, and the presence of diabetic complications. Neurological consequences of diabetes appear parallel to those observed in the aging brain. Neuroimaging studies highlight several structural cerebral changes, cortical and subcortical atrophy, beside increased leukoaraiosis that occurs in association with diabetes. There is supporting evidence from many hypotheses to explain the pathophysiology of cognitive decline associated with diabetes. The main hypotheses pointing to the potential, implied mechanisms involve hyperglycemia, hypoglycemia, microvascular disease, insulin resistance, hyperinsulinism, hyperphosphorylation of tau protein, and amyloid-β deposition.
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi u. seemanb@hotmail.com
authors.forename: Barbara
authors.initials: B
authors.lastname: Szémán
authors.forename: Géza
authors.initials: G
authors.lastname: Nagy
authors.forename: Tímea
authors.initials: T
authors.lastname: Varga
authors.forename: Anna
authors.initials: A
authors.lastname: Veres-Székely
authors.forename: Mária
authors.initials: M
authors.lastname: Sasvári
authors.forename: Dávid
authors.initials: D
authors.lastname: Fitala
authors.forename: Adrienn
authors.initials: A
authors.lastname: Szollosi
authors.forename: Rózsa
authors.initials: R
authors.lastname: Katonai
authors.forename: Eszter
authors.initials: E
authors.lastname: Kotyuk
authors.forename: Anikó
authors.initials: A
authors.lastname: Somogyi
mesh_terms: D017668:Age of Onset; D000818:Animals; D001288:Attention; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D048909:Diabetes Complications / Q000473:pathology / Q000523:psychology; D003920:Diabetes Mellitus / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology; D005625:Frontal Lobe / Q000473:pathology; D006613:Higher Nervous Activity; D006624:Hippocampus; D006801:Humans; D049292:Leukoaraiosis; D008569:Memory Disorders / Q000209:etiology; D011597:Psychomotor Performance; D013850:Thinking