Journal List > J Korean Neuropsychiatr Assoc > v.51(5) > 1017592

Hwang, Min, Kwon, Cheon, Park, Chai, and Kim: Neurocognitive Function Impairment in Alcohol Dependent Patients with Diabetes Mellitus

Abstract

Objectives

Diabetes and alcohol dependence are considered as independent risk factors for cognitive impairment. This research was to investigate whether cognitive functions in diabetic alcohol dependent patients were more impaired than non-diabetic alcohol dependent patients.

Methods

A cross-sectional study was conducted in alcohol dependence patients (n=138). Patients with alcohol dependence diagnosed by Diagnostic and Statistical Manual of Mental Disorder, 4th edition, Text Revision underwent a 75 g oral glucose tolerance test, to classify to diabetics group and non-diabetics group. In addition to demographic and clinical characteristics, cognitive functions assessed using the Korean-Mini Mental Status Examination (K-MMSE), word list memory test, and word fluency test, word list recall test from Korean version of the consortium to establish a registry for Alzheimer's disease, and block design test, digit span test, and digit symbol test from Korean-Wechsler Adult Intellogence Scale were compared between the two groups.

Results

There was no significant difference in demographic and other clinical characteristics between the non-diabetic and diabetic alcoholic patients. Compared to non-diabetic alcoholic patients, diabetic alcoholic patients were more impaired on language of K-MMSE (p=0.028) and digit symbol test (p=0.044).

Conclusion

These findings suggest the more severe impairment of selective cognitive functions in diabetic alcoholic patients than non-diabetic alcoholic patients. Future replication of these findings in a large population is necessary.

Figures and Tables

Table 1
Demographic and clinical characteristics of nondiabetic- and diabetic-alcoholic patients
jkna-51-285-i001

Data are mean±SD. BMI : Body index mass, ADS : Alcohol Dependence Scale, VAS : Visual Analogue Scale, BDI : Beck Depression Inventory, BAI : Beck Anxiety Inventory, SD : Standardard deviation

Table 2
Comparison of neuropsychological test results between diabetic alcohol dependent patients and non-diabetic alcohol dependent patients
jkna-51-285-i002

K-MMSE : Korean-Mini Mental Status Examination, CERAD-K : Korean version of the consortium to establish a registry for Alzheimer's disease, K-WAIS : Korean-Wechsler Adult Intelligence Scale

Notes

The authors have no financial conflicts of interest.

References

1. Moonat S, Starkman BG, Sakharkar A, Pandey SC. Neuroscience of alcoholism: molecular and cellular mechanisms. Cell Mol Life Sci. 2010. 67:73–88.
2. Harper C, Matsumoto I. Ethanol and brain damage. Curr Opin Pharmacol. 2005. 5:73–78.
3. Tivis R, Beatty WW, Nixon SJ, Parsons OA. Patterns of cognitive impairment among alcoholics: are there subtypes? Alcohol Clin Exp Res. 1995. 19:496–500.
4. Parsons OA. Neurocognitive deficits in alcoholics and social drinkers: a continuum? Alcohol Clin Exp Res. 1998. 22:954–961.
5. Room R, Babor T, Rehm J. Alcohol and public health. Lancet. 2005. 365:519–530.
6. Clark DB, Thatcher DL, Tapert SF. Alcohol, psychological dysregulation, and adolescent brain development. Alcohol Clin Exp Res. 2008. 32:375–385.
7. Perry JL, Joseph JE, Jiang Y, Zimmerman RS, Kelly TH, Darna M, et al. Prefrontal cortex and drug abuse vulnerability: translation to prevention and treatment interventions. Brain Res Rev. 2011. 65:124–149.
8. Baliunas DO, Taylor BJ, Irving H, Roerecke M, Patra J, Mohapatra S, et al. Alcohol as a risk factor for type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2009. 32:2123–2132.
9. Greenhouse L, Lardinois CK. Alcohol-associated diabetes mellitus. A review of the impact of alcohol consumption on carbohydrate metabolism. Arch Fam Med. 1996. 5:229–233.
10. Wannamethee SG, Shaper AG, Perry IJ, Alberti KG. Alcohol consumption and the incidence of type II diabetes. J Epidemiol Community Health. 2002. 56:542–548.
11. Ju A, Cheon YH, Lee KS, Lee SS, Lee WY, Won WY, et al. The change of plasma ghrelin and leptin levels by the development of type 2 diabetes mellitus in patients with alcohol dependence. Alcohol Clin Exp Res. 2011. 35:905–911.
12. Pietraszek A, Gregersen S, Hermansen K. Alcohol and type 2 diabetes. A review. Nutr Metab Cardiovasc Dis. 2010. 20:366–375.
13. Reijmer YD, van den Berg E, Ruis C, Kappelle LJ, Biessels GJ. Cognitive dysfunction in patients with type 2 diabetes. Diabetes Metab Res Rev. 2010. 26:507–519.
14. Strachan MW, Reynolds RM, Marioni RE, Price JF. Cognitive function, dementia and type 2 diabetes mellitus in the elderly. Nat Rev Endocrinol. 2011. 7:108–114.
15. Kumari M, Marmot M. Diabetes and cognitive function in a middle-aged cohort: findings from the Whitehall II study. Neurology. 2005. 65:1597–1603.
16. Qiu WQ, Price LL, Hibberd P, Buell J, Collins L, Leins D, et al. Executive dysfunction in homebound older people with diabetes mellitus. J Am Geriatr Soc. 2006. 54:496–501.
17. Hudetz JA, Warltier DC. Cognitive function in older diabetic subjects with a history of alcohol abuse. Psychol Rep. 2007. 101(3 Pt 2):1125–1132.
18. Kang Y, Na DL, Hahn SH. A validity study on the Korean mini-mental state examination (K-MMSE) in dementia patients. J Korean Neurol Assoc. 1997. 15:300–308.
19. Lee JH, Lee KU, Lee DY, Kim KW, Jhoo JH, Kim JH, et al. Development of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K): clinical and neuropsychological assessment batteries. J Gerontol B Psychol Sci Soc Sci. 2002. 57:P47–P53.
20. Yeom TH, Park YS, Oh KJ, Kim JG, Lee YH. K-WAIS Manual. 1992. Seoul: Korea Guidance.
21. Lee DK, Shin JK, Yun SM, Byun WT. A reliability and validity study of the Korean version of the alcohol dependence scale in alcoholics. J Korean Acad Addict Psychiatry. 2000. 4:30–37.
22. Hahn HM, Yum TH, Shin YW, Kim KH, Yoon DJ, Chung KJ. A standardization study of Beck Depression Inventory in Korea. J Korean Neuropsychiatr Assoc. 1986. 25:487–500.
23. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988. 56:893–897.
24. Blasetti A, Chiuri RM, Tocco AM, Di Giulio C, Mattei PA, Ballone E, et al. The effect of recurrent severe hypoglycemia on cognitive performance in children with type 1 diabetes: a meta-analysis. J Child Neurol. 2011. 26:1383–1391.
25. Pereda Muñoz M, Ayuso Mateos JL. [Applications of neuropsychology in the medical field: diabetes mellitus as a model of research]. Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1996. 24:322–330.
26. Sullivan EV, Rosenbloom MJ, Pfefferbaum A. Pattern of motor and cognitive deficits in detoxified alcoholic men. Alcohol Clin Exp Res. 2000. 24:611–621.
27. Park JE, Suh GH, Lee TY, Yuen HJ, Lee JN. Comparison between Alcohol Dependence and Alzheimer Disease in the Elderly Patients using the Cognitive Assessment Reference Diagnoses System. J Korean Geriatr Soc. 2007. 11:9–16.
28. Geibprasert S, Gallucci M, Krings T. Alcohol-induced changes in the brain as assessed by MRI and CT. Eur Radiol. 2010. 20:1492–1501.
29. den Heijer T, Vermeer SE, van Dijk EJ, Prins ND, Koudstaal PJ, Hofman A, et al. Type 2 diabetes and atrophy of medial temporal lobe structures on brain MRI. Diabetologia. 2003. 46:1604–1610.
30. Joe KH, Kim YK, Kim TS, Roh SW, Choi SW, Kim YB, et al. Decreased plasma brain-derived neurotrophic factor levels in patients with alcohol dependence. Alcohol Clin Exp Res. 2007. 31:1833–1838.
31. Jung KI, Ju A, Lee HM, Lee SS, Song CH, Won WY, et al. Chronic ethanol ingestion, type 2 diabetes mellitus, and brain-derived neurotrophic factor (BDNF) in rats. Neurosci Lett. 2011. 487:149–152.
32. Min JA, Lee HR, Kim JI, Ju A, Kim DJ, Kaang BK. Impairment of long-term potentiation in the hippocampus of alcohol-treated OLETF rats. Neurosci Lett. 2011. 500:52–56.
TOOLS
Similar articles