Diabetes and cognitive decline: Challenges and future direction

doi:10.4239/wjd.v14.i6.795

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World Journal of Diabetes

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1948-9358

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World J Diabetes. Jun 15, 2023; 14(6): 795-807
Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.795

Diabetes and cognitive decline: Challenges and future direction

Norhamidar Ab-Hamid, Norsuhana Omar, Che Aishah Nazariah Ismail, Idris Long

Norhamidar Ab-Hamid, Idris Long, Biomedicine program, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia

Norsuhana Omar, Che Aishah Nazariah Ismail, Department of Physiology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia

Author contributions: Long I and Ab-Hamid N prepared the manuscript; Ismail CAN and Omar N proofread this manuscript.

Supported by the Fundamental Research Grant Scheme (FRGS) Ministry of Higher Education Malaysia, No. FRGS/1/2020/SKK0/USM/03/5.

Conflict-of-interest statement: All authors report having no relevant conflicts of interest for this article.

Corresponding author: Idris Long, PhD, Academic Research, Senior Lecturer, Biomedicine program, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Jalan Hospital USM, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia. idriskk@usm.my

Received: December 25, 2022
Peer-review started: December 25, 2022
First decision: January 3, 2023
Revised: February 7, 2023
Accepted: May 6, 2023
Article in press: May 6, 2023
Published online: June 15, 2023
Processing time: 171 Days and 17.8 Hours

Abstract

There is growing evidence that diabetes can induce cognitive decline and dementia. It is a slow, progressive cognitive decline that can occur in any age group, but is seen more frequently in older individuals. Symptoms related to cognitive decline are worsened by chronic metabolic syndrome. Animal models are frequently utilized to elucidate the mechanisms of cognitive decline in diabetes and to assess potential drugs for therapy and prevention. This review addresses the common factors and pathophysiology involved in diabetes-related cognitive decline and outlines the various animal models used to study this condition.

Keywords: Diabetes mellitus; Insulin signaling; Macrovascular disease; Microvascular disease; Animal models; Cognitive decline; Pathophysiology

Core Tip: Diabetes can induce cognitive decline, a phenomenon attributed to fluctuations in glycemic status, macrovascular and microvascular disease, deterioration of insulin signaling, neuroinflammation, mitochondrial dysfunction, increases in advanced glycation end products, the effects of drugs used to treat diabetes, and diabetic autonomic dysfunction. Various animal models have been constructed to examine the pathophysiology of diabetes-induced cognitive decline.