Thambisetty M, Jeffrey Metter E, Yang A, Dolan H, Marano C, Zonderman AB, Troncoso JC, Zhou Y, Wong DF, Ferrucci L, Egan J, Resnick SM, O'Brien RJ. Glucose intolerance, insulin resistance, and pathological features of Alzheimer disease in the Baltimore Longitudinal Study of Aging. JAMA Neurol. 2013 Sep 1;70(9):1167-72. PubMed.
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Comments
University of Ulster
The study has a major flaw in my opinion. There are subjects in this study who took medication for diabetes, which may well have a large effect on the outcome. I am actually a bit surprised by the study design. It has been proposed for many years now that anti-diabetic medication, such as insulin and incretins, have neuroprotective properties, and there are a number of studies that show this, for example the recent clinical trial of exendin-4 in Parkinson’s disease (Aviles-Olmos et al., 2013). Yet, the researchers of this study do not see this as a major issue. Out of 197 subjects, 30 had taken medication against diabetes.
They then try to address this issue by looking at that subset of patients who take medication to see if there is an effect, but they only have 30 subjects for this study, of which only 9 took insulin. This is way too underpowered. I think this analysis attempts to do too many things at once. Instead of just looking at people who had never taken medication, or at people who had taken different types of medications, they mix these different cohorts together.
References:
Aviles-Olmos I, Dickson J, Kefalopoulou Z, Djamshidian A, Ell P, Soderlund T, Whitton P, Wyse R, Isaacs T, Lees A, Limousin P, Foltynie T. Exenatide and the treatment of patients with Parkinson's disease. J Clin Invest. 2013 Jun 3;123(6):2730-6. PubMed.
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