RESUMEN
Metabolic and neurodegenerative disorders have a growing prevalence in Western countries. Available epidemiologic and neurobiological evidences support the existence of a pathophysiological link between these conditions. Glucagon-like peptide 1 (GLP-1), whose activity is reduced in insulin resistance, has been implicated in central nervous system function, including cognition, synaptic plasticity, and neurogenesis. We review the experimental researches suggesting that GLP-1 dysfunction might be a mediating factor between Type 2 diabetes mellitus (T2DM) and neurodegeneration. Drug treatments enhancing GLP-1 activity hold out hope for treatment and prevention of Alzheimer's disease (AD) and cognitive decline.
Asunto(s)
Trastornos del Conocimiento/etiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/fisiopatología , Péptido 1 Similar al Glucagón/fisiología , Animales , Trastornos del Conocimiento/metabolismo , Trastornos del Conocimiento/fisiopatología , Trastornos del Conocimiento/prevención & control , Diabetes Mellitus Tipo 2/metabolismo , Endocrinología/métodos , Endocrinología/tendencias , Péptido 1 Similar al Glucagón/deficiencia , Péptido 1 Similar al Glucagón/metabolismo , Péptido 1 Similar al Glucagón/uso terapéutico , Humanos , Resistencia a la Insulina/fisiología , Degeneración Nerviosa/tratamiento farmacológico , Degeneración Nerviosa/etiología , Degeneración Nerviosa/metabolismo , Terapias en Investigación/métodos , Terapias en Investigación/tendenciasRESUMEN
BACKGROUND: Although antidepressant drugs (ATD) are frequently prescribed to patients with Alzheimer's disease (AD), their effect on cognitive status has been only rarely assessed. METHODS: The impact of depressive symptoms and ATD on cognitive status was retrospectively assessed in 72 older AD outpatients with mild-to-moderate cognitive impairment, treated with cholinesterase inhibitors, over a 9-month follow-up. RESULTS: Compared to subjects without baseline depressive symptoms, those with symptoms who were continuously treated with ATD had less cognitive decline; those never treated, or not continuously treated despite baseline symptoms, had an intermediate trend. Such a protective action of ATD was, at least in part, independent of their action on depressive symptoms. CONCLUSION: These observations suggest that ATD may reduce cognitive decline in depressed older AD patients.
Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Antidepresivos/administración & dosificación , Trastornos del Conocimiento/tratamiento farmacológico , Cognición/efectos de los fármacos , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/psicología , Trastornos del Conocimiento/psicología , Depresión/tratamiento farmacológico , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
Thirty years after its publication, the Mini-Mental State Examination is still the most widespread and reliable instrument of cognitive assessment in geriatric clinical practice. Here we discuss the causes of its wide acceptance and diffusion all over the world until today and the reasons for using it also in the forthcoming years.
