Physiologic and Sociobehavioral Mechanisms for Cognitive Impairments and Dementia: A Focus on Hyperglycemia

Talley, Michele H.

Saturday, 16 November 2013

Michele H. Talley, MSN, ACNP-BC¹
Anne Wojner Alexandrov, PhD, RN, CCRN, FAAN²
Andrei Alexandrov, MD³
David E. Vance, PhD, MGS⁴
David Liebeskind, MD, FAHA, FAAN⁵
Erica Pryor, PhD, RN²
Virginia G. Wadley, Ph.D.⁶
(1)School of Nursing; Adult/Acute Health, Chronic Care and Foundations Department, University of Alabama at Birmingham, Birmingham, AL
(2)School of Nursing, University of Alabama at Birmingham, Birmingham, AL
(3)Director, Division of Cerebrovascular Disease; Director, UAB Comprehensive Stroke Research Center, University of Alabama at Birmingham, Birmingham, AL
(4)Director for the Center for Nursing Research, University of Alabama at Birmingham, Birmingham, AL
(5)Stroke Center, University of California, Los Angeles, Los Angeles, CA
(6)Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL

Learning Objective 1: The learner will be able to communicate 2-3 physiologic factors associated with hyperglycemia postulated to be mechanisms for cognitive impairments and dementia.

Learning Objective 2: The learner will be able to express 2-3 sociobehavioral factors associated with hyperglycemia postulated to be mechanisms for cognitive impairments and dementia.

If present trends remain, by 2050 approximately 16 million Americans will acquire Alzheimer’s disease. An even greater percentage of the population will experience a milder form of dementia, known as cognitive impairment. Determining modifiable risk factors for mild and severe cognitive impairment is of the utmost urgency. In order to develop the state of the science related to risk factors or physiologic hypotheses related to cognitive impairment, this paper will review the studies available to evaluate the physiologic and sociobehavioral mechanisms for dementia. The University of Alabama Lister Hill Library was used to search the PUBMED and CINAHL databases for controlled studies performed in the last 10 years on adults. Many studies have been performed to determine the risk factors associated with cognitive impairment. Both acute and chronic hyperglycemia has been noted to have significant associations with cognitive impairment. Additionally, age and duration of diabetes have been noted to contribute to earlier and steeper cognitive impairment. In addition, many physiologic mechanisms were explored to assist in identifying interventions for providers to consider in avoiding early cognitive impairment or its progression.

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