Diabetes and preclinical AD

 
   Lead Investigator:    Jill Morris
   Institution      :    KU Medical Center
   E-Mail           :    jmorris2@kumc.edu
   Proposal ID      :    302



   Proposal Description:
   The current project will utilize the NACC dataset to investigate the relationship between Type 2 Diabetes (T2D) and AD neuropathology. Data will be organized into 3 cohorts: aging (normal clinical diagnosis, absence of AD neuropathology), preclinical AD (normal clinical diagnosis, AD neuropathology at autopsy), and AD (clinical AD diagnosis, AD neuropathology at autopsy). We will assess the frequency of T2D in each cohort. We will then determine if Apolipoprotein E ??4 (APOE e4) related risk for AD neuropathology (genetic risk) is compounded by a diabetes diagnosis (environmental risk). It is unclear why some individuals with AD neuropathology at time of death do not have a clinical AD diagnosis. It is possible that these individuals represent a ???preclinical AD??? group and that they would have eventually developed AD. It is also possible that additional factors (i.e. metabolic dysfunction) in addition to neuropathology may compound neuropathology and affect clinical expression of symptoms and eventual AD diagnosis.                                                                                                                   Aim 1. We will assess the frequency of diabetes diagnosis in three groups: subjects with neither AD diagnosis nor neuropathology at autopsy (cohort 1), individuals with no clinical AD diagnosis during life but positive for AD neuropathology at autopsy (???preclinical AD??? cohort 2) and subjects with both diagnosed AD and AD neuropathology (cohort 3).                                                                                                                 Aim 2. We will assess whether APOE ??4 genotype and diabetes diagnosis together are related to greater AD neuropathology than either condition separately. APOE ??4 genotype has been linked to increased AD risk. If metabolic dysfunction, which is potentially treatable, exacerbates genetic risk, this presents a potential target for treatment.