Wednesday, 20 August 2003
This presentation is part of : Interface of Medicine and Psychiatry in Psychogeriatrics I

S071-005 Insulin Resistance May Link Affective Disorders and Alzheimer’s Disease: A Missing Link Hypothesis

Natalie Rasgon, Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA and Lissy Jarvik, Psychiatry, UCLA, Los Angeles, CA, USA.

Numerous lines of evidence link affective disorders (ad) with disorders of cognition. Significant overlap exists in the phenotypic, behavioral, and physiological presentations of ad and Alzheimer's Disease (AD). We suggest that insulin resistance (IR) constitutes a missing link between ad and AD. We also propose that there are potential pathophysiological explanations for this link. Inadequate glucose utilization resulting from IR may underlie the hypometabolic changes in crucial brain regions observed among patients with ad. In those with persistent IR, such changes may progress to the more permanent changes characteristic of dementia, especially in individuals with other risk factors for dementia. As clinical, biochemical and neuroimaging evidence already exists linking ad and AD to IR, the hypothesis that IR links ad and AD warrants testing, not only because of its theoretical implications, but also because of its practical consequences. According to our hypothesis, ad non-responders (and maybe even some responders) with IR, compared to ad patients without IR, are subject to more pronounced metabolic changes in the above mentioned critical cerebral regions. And these metabolic changes persisting over prolonged periods of time, may eventually lead to irreversible brain changes.

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