الفهرس 
DementiaOnly 14 pages are availabe for public view
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Abstract
Dementia is the loss of mental functions -- such as thinking, memory, and reasoning -- that is severe enough to interfere with a person’s daily functioning. Dementia is not a disease itself, but rather a group of symptoms that are caused by various diseases or conditions.
Diabetes mellitus is a metabolic disease characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long term damage, dysfunction and failure of various organs, especially the eye, kidney, nerves and blood vessels.
Hyperglycemia is the land mark of this metabolic syndrome and is the parameter most closely monitored to make diagnosis and to judge therapy.
Reviews on the epidemiological studies on cognitive impairment in patients with DM found evidence of cross-sectional and prospective associations between type 2 DM and moderate cognitive impairment, on memory and executive functions. There is also evidence for an elevated risk of both vascular dementia and AD in patients with type 2 DM.
Furthermore aging is characterized by a significant decline of metabolic and hormonal functions, which often facilitates the onset of severe age-associated pathologies. Decreases in serum IGF-1 as potential mechanisms that may influence cognitive function in the elderly.
The study was conducted on 40 subjects with age range from 60 to 81 years attending the inpatient and the outpatient clinic of geriatric department Ain Shams University hospital. They were classified into the following groups:
Group I The patients with dementia:
Included 30 Patients with dementia, those were subdivided into two sub groups according to history of Diabetes Mellitus as follow:
Group Ia: 15 participants with dementia and type2 diabetes (T2DM)
Group Ib: 15 demented non diabetic participants
- Group II: The control group:
Included 10 healthy subjects, age and sex matched to group I
The results were statistically analyzed and it was found that:
• IGF-1 was lower in subjects with dementia than control subjects and it was statically significant with P value <0.001.
• Patients with dementia and type two diabetes mellitus (T2DM) show the lowest levels of IGF-1 among the studied groups and it was statically significant with P value <0.001.
• MMSE score was lower in dementia with (T2DM) than subjects with dementia only and it was statically significant with P value <0.05.
• There was a highly positive significant correlation between IGF-1 levels and MMSE score among the studied groups with P value <0.001.
• As regard sensitivity and specificity; it was found that IGF-1 is considered better negative than positive test with higher specificity than sensitivity.
According to these data, the decrease in serum IGF-I levels is strongly related to the cognitive function as well as the presence of (T2DM) or not.
Low serum IGF-I beside presence of DM is an important risk factors in the pathogenesis of Dementia either it was VaD or Alzheimer’s disease