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Conference Support Program Application Abstract

Mechanisms of Central versus Peripheral Insulin Resistance
Natalia Rasgon   (Stanford, CA)
There is widespread agreement that type 2 diabetes/insulin resistance (T2D/IR) roughly doubles the risk of cognitive decline and dementia. About one half of patients with metabolic syndrome (MS) develop cognitive impairment (CI). The aging of the baby boom and the skyrocketing prevalence of midlife obesity are driving an epidemic that has been nicknamed “the silver tsunami.” At the current pace, the entire Medicare budget will be required for dementia care by the year 2050. Despite the consensus on the association of T2D/IR and MS with CI, a detailed characterization and classification that is recognized by experts from all fields is not well established. The current NINDS formulation is that diabetes with dementia is a subtype of vascular CI/D (VCID), but this leaves entirely unaddressed the phenomenon of “brain IR”, an entity that is frequently mentioned but uncharacterized at the cellular or molecular levels. This meeting considers this vexing challenge in the context of how one might achieve allostasis through mechanisms that are beneficial to any of the various proposed bases for risk; e.g., control of body mass in midlife and the importance of physical exercise are two such factors. With recent evidence from Sweden and the UK that diet and lifestyle changes can reduce prevalence of dementia, there are compelling reasons to understand at the system, cellular and molecular levels exactly how these beneficial effects are achieved.
Data for this report has not yet been released.