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. 2021 Nov;17(11):1769-1778.
doi: 10.1002/alz.12482. Epub 2021 Oct 12.

The impact of diabetes on cognitive impairment and its progression to dementia

Abigail Dove  1 , Ying Shang  1 , Weili Xu  1 , Giulia Grande  1 , Erika J Laukka  1   2 , Laura Fratiglioni  1   2 , Anna Marseglia  1   3
Affiliations

The impact of diabetes on cognitive impairment and its progression to dementia

Abigail Dove et al. Alzheimers Dement. 2021 Nov.

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.

Keywords: cognitive impairment; dementia; heart disease; inflammation; population-based cohort study; type 2 diabetes.

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References

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