The impact of diabetes on cognitive impairment and its progression to dementia
Open Access
- 12 October 2021
- journal article
- research article
- Published by Wiley in Alzheimer's & Dementia
- Vol. 17 (11), 1769-1778
- https://doi.org/10.1002/alz.12482
Abstract
Introduction Diabetes is a well-established risk factor for dementia, but its impact on the prodromal phase of dementia is unclear. Methods Cohorts of older adults who were cognitively healthy (n = 1840) or had cognitive impairment-no dementia (CIND; n = 682) were followed over 12 years to detect incident CIND and dementia, respectively. Results Poorly controlled diabetes (glycated hemoglobin [HbA1c] ≥7.5%; reference = normoglycemia) was associated with double the risk of CIND (Cox regression multi-adjusted hazard ratio [HR] 2.01, 95% confidence interval [CI] 1.13-3.58) and triple the risk CIND progressing to dementia (HR 2.87, 95% CI 1.20-6.85). Co-morbid diabetes and heart disease doubled the risk of incident CIND and dementia, although neither disease conferred a significant risk of either outcome alone. Elevated systemic inflammation contributed to the diabetes-associated increased dementia risk. Conclusions Diabetes characterized by poor glycemic control or cardiovascular complications is related to a greater risk of the development and progression of cognitive impairment. Inflammation may play a role in these relationships.Funding Information
- Vetenskapsrådet
- National Natural Science Foundation of China
- Alzheimerfonden
- Gun och Bertil Stohnes Stiftelse
- Stiftelsen för Gamla Tjänarinnor
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