Objective:
The main objective of the study was to analyze the association between insulin resistance (IR ) at  diagnosis and the development of dementia in the following 10 years in patients with Parkinson’s disease diagnosed between 2008-2009 at the Infanta Sofia University Hospital (HUIS). Secondarily, the association between diabetes mellitus, hypercholesterolemia and hypertension and the development of dementia was also analyzed in these patients.

Background: Among the symptoms associated with Parkinson’s disease, dementia stands out for its high impact on the quality of life of patients. Insulin resistance has been linked as a risk factor for cognitive decline, which is of interest due to its increasing incidence.

Method: Observational, analytical, retrospective and longitudinal study. A total of 173 patients diagnosed with Parkinson’s disease between 2008 and 2009 were included, who underwent a blood test in the year of diagnosis and who are monitored in the HUIS. Data collection was carried out by reviewing medical records. Chi-square test and Fisher’s exact test were used for statistical analysis.

Results: Of the 173 patients included in the study, 76 had IR at diagnosis.
Of the 76 with IR,  46 developed dementia (60%) with an RR of 1.5 (95% CI: 1.2-4.7).
In addition, of the 48 patients who had DM, 33 developed dementia (67%), of the 22 patients who had hypercholesterolemia, 13 developed dementia (59%) and
of the 21 patients who had hypertension, 12 developed dementia (57%)

Conclusion:
This study demonstrates that insulin resistance acts as a risk factor for the development of dementia in Parkinson’s patients. It hasn’t been possible to establish a relationship between Diabetes Mellitus, hypercholesterolemia and hypertension and the development of dementia in these patients.

References: 1. Aarsland, D., Andersen, K., Larsen, J. P., Lolk, A., Nielsen, H., and Kragh- Sorensen, P. (2016). Risk of dementia in Parkinson’s disease: a community- based, prospective study. Neurology 56, 730–736. doi: 10.1212/WNL.56. 6.730 2. Litvan, I., Aarsland, D., Adler, C. H., Goldman, J. G., Kulisevsky, J., Mollenhauer, B., et al. (2015). MDS Task Force on mild cognitive impairment in Parkinson’s disease: critical review of PD-MCI. Mov. Disord. 26, 1814–1824. doi: 10.1002/ mds.23823 3. Xu, W., Liu, F.-T., Li, J.-Q., Cao, X.-P., Tan, L., … Yu, J.-T. (2019). Modifiable risk factors for cognitive impairment in Parkinson’s disease: A systematic review and meta-analysis of prospective cohort studies. Movement Disorders : Official Journal of the Movement Disorder Society, 34(6), 876–883. https://doi.org/10.1002/mds.276654893 4. Xu, W., Qiu, C., Gatz, M., Pedersen, N. L., Johansson, B., and Fratiglioni, L. (2016). Mid- and late-life diabetes in relation to the risk of dementia: a population- based twin study. Diabetes Metab. Res. Rev. 58, 71–77. doi: 10.2337/db08- 0586 5 Yang, L., Wang, H., Liu, L., & Xie, A. (2018). The Role of Insulin/IGF-1/PI3K/Akt/GSK3β Signaling in Parkinson’s Disease Dementia. Frontiers in Neuroscience, 12, 73. https://doi.org/10.3389/fnins.2018.00073 6. Bohnen, N. I., Kotagal, V., Müller, M. L. T. M., Koeppe, R. A., Scott, P. J. H., Albin, R. L., … Petrou, M. (2014). Diabetes mellitus is independently associated with more severe cognitive impairment in Parkinson disease. Parkinsonism & Related Disorders, 20(12), 1394–1398. https://doi.org/10.1016/j.parkreldis.2014.10.008

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MDS Abstracts - https://www.mdsabstracts.org/abstract/association-between-insulin-resistance-and-development-of-dementia-in-patients-with-parkinsons-disease/