Depression Plus Diabetes May Boost Dementia Risk

15th April 2015 was celebrated as Health Day. Medline Plus, an on line health information magazine of U.S National Library of Medicine has published the following. Pasted here by me for knowledge of those interested.

Each threatens brain health, and combination is worse, study suggests

URL of this page: (*this news item will not be available after 07/14/2015)

Wednesday, April 15, 2015

WEDNESDAY, April 15, 2015 (HealthDay News) -- Depression and diabetes are each hard on the brain, and having both conditions may significantly raise the risk of dementia, according to new research.

"What this argues for is, we need to do a better job of both identifying diabetes and depression and then really treating them once identified," said study researcher Dr. Dimitry Davydow, an associate professor of psychiatry and behavioral sciences at the University of Washington School of Medicine in Seattle.

His team looked at dementia risk among 2.4 million people in Denmark, age 50 and older, who had depression, type 2 diabetes or both, and compared them with people who had neither condition.

The researchers also took into account pre-existing medical conditions, such as cerebral vascular problems, complications such as kidney problems and other ailments.

"Even after taking those into account, diabetes itself raised the risk of dementia by 15 percent, depression by 83 percent and the two together by 107 percent," Davydow said.

The association was especially strong in people younger than 65. In that age group, "a quarter of the cases [of dementia] were attributed to depression and diabetes," he said.

In Western populations, type 2 diabetes and major depression are increasingly common. And as many as 20 percent of people with diabetes, which is rapidly increasing in younger groups, also have depression, the researchers said in background notes with the study.

"To our knowledge, this is the first study to look at this issue in this way," Davydow said. The findings were published online April 15 in JAMA Psychiatry.

The study points out a complicated link between depression, diabetes and dementia, but does not establish a direct cause-and-effect relationship.

"There is lots of evidence that those who struggle with depression are more likely to develop chronic medical problems like diabetes and heart disease and high blood pressure," Davydow said.

"They are less likely to take medications if they are depressed. Those who have diabetes are more likely to suffer from depression," he added.

Moreover, diabetes makes it more likely that plaque will develop in blood vessels, which can lead to strokes and dementia, Davydow said.

Diabetes and depression each threaten brain health, said Dr. Charles Reynolds III, of the University of Pittsburgh Medical Center, and author of a commentary accompanying the study.

Both ''pose threats to vascular health, thereby impeding maintenance of healthy brain aging and functioning, and posing a risk for cognitive decline," he said.

Reynolds urged those who have a combination of diabetes and depression to get treatment for both in order to protect their brain.

"Lifestyle choices, such as increasing physical activity, will also benefit the management of both conditions," he added.

The research team -- led by Davydow and the study's recently deceased first author, Dr. Wayne Katon -- followed the study participants from 2007 through 2013. All patients were dementia-free at the start.

The researchers said nearly 20 percent of participants had a diagnosis of depression, about 9 percent had diabetes, and nearly 4 percent had both.

Over the study period, more than 59,600 men and women (2.4 percent) got dementia -- at age 81, on average. Of those, 26 percent had only depression, 11 percent had only type 2 diabetes and nearly 7 percent had both.

SOURCES: Dimitry Davydow, M.D., M.P.H., associate professor, psychiatry and behavioral sciences, University of Washington School of Medicine, Seattle; Charles Reynolds III, M.D., professor, geriatric psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pa.; April 15, 2015, online JAMA Psychiatry

Page last updated on 16 April 2015

49 Replies

  • nice post sir.

  • thanks for your reading the post. It would be pleasure to read your views on the information.

  • I am on both anti-diabetic and anti-depressant medication since more than 18 years.Depression definitely aggravates diabetes,as it happened in my case,when I stopped anti-depressant for about an year on doctor's advise and the Hb A1c figure showed a steady increase until I restarted the medication.Regarding dementia,I have no experience so far,but I am apprehensive about it.Thank you sir,for the very relevant and valuable post.

  • venkataramana

    my post related to the topic "depression and diabetes are hard on brain. It may lead to dementia "The discussion here is again on LCHF.I am disappointed. Irrespective of topic these persons use the opportunity to broad cast their pet topic whether it is relevant or not They twist and tort to bring to focus their own pet subject most often cooking up arguments just for its sake.. I don't see any merit in saying the same thing again and again. I wonder why many of the bloggers are silent and why they do not raise their voice against such deviations.

    Depression is not a physical ailment but something to do psychological impact on our mind for various reasons including stress, disappointment in life, decrease in self confidence/esteem constant ill treatment etc.,which many people are prone to including loneliness, death in family and other reasons. I would have appreciated if these psychological issues were discussed.

  • I checked your profile and did not find any .kindly update your file so that I can give response

  • I can only say that it is distressing.

  • sir., on the surface of it., brain being not able to effectively utilise glucsoe is first cut impression. that being apart., the ossified beleif systems and thought processes of the patients , coupled with not being in sync with time of their immediate near., may give rise to the phenomenon of dementia,depession, etc.(my personal opinion.) its a relative state sir.

  • if I am permitted to air my own views, it is an established medical fact that brain is one organ that entirely depends on glycogen ( synthesised from food we eat) At all times this is made available by our system as otherwise we will die .This is body's way to sustain life even when prolonged non availability of food for any reason such as strenuous fasting eating food deficient in certain respects .Minor shortage of glycogen causes dementia in my feeling and total non availability causes death. It is said that our system strives hard to ensure availability of this by converting fat stored in liver and muscles if energy producing food is not available. It is necessary that our food should have some amount of carbohydrate as part of our food intake although its harmful effect has been discussed here in case of heart health. and in controlling diabetes etc.

    ,I am open to correction.

  • Actually No wrt brain being entirely glucose dependent. It works better on ketones. The longest continuous fast is of 350+ days where the person was just given electrolytes and body fat was being burned for energy.

  • How about in the normal day to day life when no fast is undertaken? can you elaborate on the concept of conversion of fat to glycogen on demand mentioned earlier by you in another context.

  • Is electrolyte not glucose based?what is its composition?

  • Sodium Citrate-0.58 gm

    Dextrose-2.7 gm

    Sodium Chloride-0.52 gm

    Potassium Chloride-0.3 gm

    typical composition per tablet. in fasting ,glucose is still needed., at least thru gluconeogenisis.(thru protein breakdown). the only thing is the persons may not be taking any solidfoods. and if only nacl and kcl are supplied along with sodium citrate, it may be suffice. i think glucose can still be generated thru glycols i.e fat path.

    Meetu., correct me if wrong.

  • Is it not in essence a mixture of salt and sugar.Is it not?

  • yes

  • in terms of percentage the sugar content of the tablet works out to 65.86%.With this the 60& mentioned by meetu i77 is less than what is administered to persons on fast. The purpose is to correct the impression that 2.7 grams is far less than 60%.

  • ok sir.

  • sir., it is a 4gm tablet as i read. so glucose may not be 2.7 but 25x2.7=67.5%. sorry i did not mention tablet weight. BUT that is for immediate recovery. depending on case i think more tablets may be administred. (in absense of saline) basically for sunstroke cases.which can be thought similar to extreme fasting and falling unconscious.

  • I don't think the amount of glucose pushed would be anywhere near the 60% carb diet, because on such a high glucose level insulin levels will also run high and fat will not burn.

    That said, I remember reading (can't recall the URL) that 30 grams glucose per day is what cannot be replaced at all by ketones. This is the reason that on long fasts, person starts losing half an ounce to one ounce muscles per day if this is not compensated externally. This is for generating glucose through gluconeogenisis as sridhar1 said.

    I am not too sure if this "30 gram non replaceable glucose" is also the basis of Dr Richard Bernstien's 6:12:12 grams carb rule.

  • accepted. bare minimum glucose is produced as body tends to preserve stocks better thn our intelligence.and also to assist ketosis.?????

  • @sridhar1 --

    Yes - Nutritional Ketosis (NK) is a healthy state of body. However, being keto-adapted takes time. The fastest to enter this state is what is known as FAT fasting -- ie doing fast with fat (VCO Wins here, being MCT) only as intake and taking some proteins. Even on this it can take as long as 5 days to enter into NK. Then comes the adaptation stage which can extend right upto 2 months. This is why, some recent study aimed as demonizing fat within just 5 days makes absolutely no sense.

    Most who talk against Ketones mix NK with DKA as usual.

    Anyways, this is just a theoretical point as we don't follow a ketogenic diet. Ketogenic diet is a subset of LCHF.

  • I came across this article which is relevant to the topic.

  • I found these relevant to the topic and vindicates our stand too:

    As usual the opposite camp will still defend the broken USDA pyramid which has caused havoc in human health. Experts feel so threatened that they will keep ignoring the obvious, while on the lookout for the next drugs that can earn them trillions. Fueling the brain with ketones is best drug. It's known since 1920's

    Just telling what is obvious (Diabetes May Boost Dementia Risk) is not enough. They never tell WHY?

    Is it the so called safe limit of ADA unsafe? At least that's the most obvious answer to WHY!

  • Sir., as i understand ketogenic diets are recommended for alzeimers disease.

    and also i was reading that brain works better on ketones too.

    but it takes time to adopt.,, and it wont be a single day affair. and if fats can be avoided , i prefer that way., bcos i would not like to keep checking what i eat.

    if anybody can manage in any way., with or without lchf or ketogenic diets., its fine and i find no reason why they should change their lifestyle. i.e if drugs are ok.

    no hard and fast rule my opinion.

  • mr Sridhar

    I have no knowledge on what you say.All I understand is fat is burnt to produce glycogen which is needed to keep brain going when it is not available as a normal biological activity of food being the source.

  • yes sir., that path also exists. i think it is called glyserol path or something like that.

  • @shrisamarth -- Yes I had read that post long back. Nutrition textbooks (which is the only thing that few prefer to refer) will have to be re-written :)

    There's a whole new world outside of textbooks.

  • It is in my bookmarks. :)

  • @Meetu77 sridhar1 has posted the same link in this thread :)

  • @shrisamath -- that's why all of us on LCHF are on the same page :)

  • can you educate me your purpose of posting this web page without any comment.In what way you felt it is relevant.?

  • The post is with reference to what sridhar1 meant about the conversion of fats to glucose.

  • cscon

    thanks.I note what you write

  • @sidhar1 --

    Dr Mary Newport has an extensive experiment done on her Alzheimer suffering husband using Virgin Coconut Oil, to prove that Ketones fuel the brain better. You can search about her case on google.

    Here's one news item on the same topic but Indian family:

    You will find many videos on same topic on youtube. Off course mainstream is not interested as VCO cannot be patented.

    Naysayers will say -- Oh Coconut Oil is Saturated fat it will CHOKE the small Indian artery like butter would choke a "small" drainpipe faster compared to larger drainpipe. Amusing logic, because fat in blood is TG and TG shoots up because of CARBS :)

    But, to go on VCO, one has to first SHUN the so called healthy diet :)

  • Saw. good.

  • looks like body can use all macro nutrients for brain functioning., someway or other.i didnot study much about brain relevance vs glucose.

  • I agree with you . our system is so designed it does not go by technical jargons of naming its various activities but knows fully what it needs to do in any situation to protect life at any cost by its ability to reacting to every thing external (to its own wisdom) .whether it is infection, accidentally hurting ourselves or type and quality of food we eat. giving very little chance to us to alter its wisdom. It is a beautiful gift of God to mankind that we are able to think when other creations are not able to. Some one remarked elsewhere that even to create a crude duplicate of our brain it requires thousands of computers wired with kilometres of wires. and probably thousands of people on a control panel to operate it. I have seen people with dementia sitting motionless not able to remember anything including to eat food placed before them. or that they should go to toilet .It is hell. Therefore it is necessary to keep our brain healthy and heed its signals of failure and remedy ourselves without dogma of this or that system of food.

    I apologise if i have said anything you did not like.if you are adhering to any particular protocol I advise you to do what you feel is right for you without getting influenced by others.

    including me.

  • @ragivrao -- We only share and preach based on our experience backed with our medical reports -- pre and post LCHF -- and not just weird OPINIONS to suit our thesis.

    Yes, we are pretty upfront about one thing. We don't trust the dietitians and doctors when it comes to diet for a diabetic. It's our body that we live in and after having failed miserably with mainstream advise we took diabetes management in our own hands and switched to LCHF and watch the medical reports more carefully than a casual high carbers would as they rely more on what doctors say. We don't follow ADA's advise on what is "Good control of diabetes". Their advise is Good for sales of drugs.

    We are not desperate so we don't rely on researches done by doctors who have been convicted for medical frauds, not just one but many. We don't rely on any studies funded by ADA or is equivalent anywhere in the world.

    It's amusing to find that some call us names like idiots, stupid, internet pests, suckers, and etc even without understanding what we say and do. We know our arteries will not choke like a narrow kitchen plumbing system compared to bigger ones in the west.

    We spend less on doctors and drugs and more on what our medical reports say is healthy food. We don't get paid to do cherry picking as far as our medical reports go so most of the time they don't concur with what mainstream says. There are many papers on dementia and diabetes on in the news section.

  • Meetu77

    At no point of time have I disrespected your views or called you names as mentioned. I have appreciated all the things you said here and encouraged you to take up the matters before the forum .There is no quarrel with you or your passionate expression of certain thoughts which you feel right.

    You can continue to pursue your vision.

    All I wanted to say in my reply to Mr Sridhar was irrespective of what we think as right the body knows too well what it should do to sustain life. It is a divine gadget which is to be protected .It gives enough signals for us to act and problem arises if we ignore its call of alert. God never takes blame for our death. It is always-- -he died of heart failure, kidney failure etc., etc., and puts blame on our failure to protect.

    I have no further to say.

    good bye.

  • @ragivrao.. Sir., please dont be hurt. as a 3rd party of this entire conversation., i fully beleive that meetu never was aggresive towards you. she has others in her mind, and the words clearly indicate. You are a respectable elderly man and i feel bad to see you withdraw hurt. sorry sir, but people like you shuld not retire hurt.

  • mr Sridhar

    I am not hurt but feel frustrated when one tries to browbeat and say the same thing again and again and cooking up arguments just for its sake as seen about dextrose percentage.

    Mr Samarth,s blog just cites a web. if you carefully study the long article it is amply clear that body manufacturers glucose by synthesising from other food through a longer process if it is not available through a direct route. Our system is far more intelligent than our thoughts. we are living because of this inherent wisdom .

    Any way thanks for your clarification

  • ok sir.

  • @ ragivrao.. Yes Sir.Really creation is a marvel. And you did not hurt me in any way sir. so no need to apologise. it only shows your refined way of thinking and etiquette. you r welcome sir.

  • DEAR FEllow lchfers.., todya got my blood work done. hb1ac 6.4 On 27.10.14 it was 7.0.. looks good so far. haemoglobin went up earlier 13.5 now 16.5, i am surprised. right from my childhood it was always low., around 11-13.

    ldl 106.8., hdl 35. total chol 169.

    on 27.10.14 hdl=42., ldl 97.,. tc 161.

    serum creatin 1.3 then and now.

    Now my question is "ldl will it reduce?" TG went up 136 from 113.

    In fact i cannot call myself strict lchf follwer., but i was just dabbling.

    Advice welcome.(From cscon and meetu specially).

    hb1ac slowly coming down from 8.5 in dec13. today 6.4. i was just dabbling in lchf way from may be jan 15 on wards. inbetween in 2014 when it was reducing tried various nexperiments on myself including homeo(dibonil)., au\yurveda etc.

    (thats my backgrund. incidentally diagnised as t2 in 2006 when i had a surgery for infection., with B.S 545 and b.p 250/130. insulin injections could not bring down the b.s on table. one senior doctor gave glimipride 2mg ., then b.s started coming down. not with injections. looks funny. he also adviced me "reduce the dosage as and when you think your b.s is coming down and u feel uncomfortable". the surgeon was around 75 years of age.)

  • Your TG/HDL ratio is slightly higher (around 4) it has to be <3.5) indicating insulin resistance. And HDL % to TC is also low (20%) It has to be more than 24%. LDL does not tell anything at this level. This could be only rise in LDL mass may not be rise in particle no. If want to assess LDL status then you need to test apo B which is much more better indicator.

  • hmmmm. ok samarth. right now not interested in apoB etc. will continue and see after 3 months again. :)

  • @sridhar1 -- Go by what @shrisamarth has said.

    Perhaps it's time to end the dabbling and join the club formally :)

  • Sure :)

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