The Impact of Glucose on Cognition in Neurodegenerative Disease
Bibliographic record
Abstract
Glucose dysregulation has been associated with poorer cognitive functioning in healthy adults with and without diabetes, as well as in individuals with neurodegenerative disease. In addition to cognitive changes, hyperglycemia has also been associated with brain atrophy, and this is especially true for those with the apolipoprotein E (ApoE) ε4 genotype. However, most of these studies rely on cognitive screening measures of dementia with vast variations in how cognition is assessed. This precludes the ability to make conclusive inferences from findings that have not assessed cognition consistently nor comprehensively. \n\nIn the present study, the effects of glucose on cognition were examined across healthy aging, and two neurodegenerative diseases, namely Alzheimer’s (AD) and Parkinson’s disease (PD), with the goal of assessing cognition in a detailed and standardized manner across cohorts. Data from the Ontario Neurodegenerative Disease Research Initiative was used to assess three cohorts of healthy adults and individuals with AD and PD. The primary interest was to analyze the effects of elevated glucose levels on cognition after controlling for related covariates of triglycerides, hypertension, and smoking. Secondary analyses examined the roles of genetics, and brain volume with glucose. \n\nHigher glucose levels were differentially related to disease status and cognitive abilities after controlling for the effects of triglycerides, hypertension, and smoking. In healthy adults and those with PD, glucose levels were associated with poorer cognition, but not in those with AD. Among healthy adults, this effect was due to worse language and visuospatial abilities whereas widespread cognitive changes over domain-specific impairment was observed in those with PD. In AD, glucose levels were not associated with cognition. No significant interaction emerged between ApoE-ε4 carriers and glucose in neurodegenerative disease. An interaction between lower brain volume and poorer cognition was observed among those with higher glucose levels in the healthy adult group but not in the PD or AD groups.\n\nHyperglycemia appears to have a different relationship in those with and without neurodegenerative disease. In healthy adults, it may be possible that even glucose levels within the normal range may be exerting deleterious effects that manifest clinically, affecting both cognition and brain volume. In neurodegenerative disease, more research is needed to understand the complex relationship between hyperglycemia and specific disease pathology. With the consistent increase in both diabetes and dementia, close monitoring of glucose levels may be a potential modifiable risk factor that contributes to optimal brain health to reduce the risk of a dementia diagnosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".