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January 2011

Should We Target Insulin Resistance to Prevent Dementia Due to Alzheimer Disease?

Author Affiliations

Author Affiliations: Departments of Medicine (Dr Luchsinger) and Neurology (Dr Small), Columbia University Medical Center, and Department of Epidemiology, Joseph P. Mailman School of Public Health (Dr Luchsinger), Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Dr Small), and Gertrude H. Sergievsky Center (Dr Small), Columbia University, New York, New York; and Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands (Dr Biessels).

Arch Neurol. 2011;68(1):17-18. doi:10.1001/archneurol.2010.339

The article by Baker et al1 in this issue of the Archives is an important piece of evidence supporting the hypothesis that insulin resistance contributes to Alzheimer disease (AD). Baker et al report that insulin resistance in persons with normal cognition and prediabetes or early diabetes without treatment is associated with reductions in cerebral glucose metabolic rate (CMRglu) measured with fludeoxyglucose F 18–positron emission tomography (FDG-PET) in frontal, temporoparietal, and cingulate regions, similar to those observed to predict the development of clinical AD. In addition, persons with prediabetes and type 2 diabetes demonstrated a different pattern of brain activation during a memory encoding task. Based on these results, Baker et al propose that insulin resistance could be an early marker of AD.

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