Diabetes Ups Risk of All-Cause Dementia, Alzheimer's Disease

Postload but not fasting glucose levels tied to higher Alzheimer's, all-cause, and vascular dementia risk

TUESDAY, Sept. 20 (HealthDay News) -- Patients with diabetes have an increased risk of developing all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) than those with normal glucose tolerance, with elevated two-hour postload glucose (PG) but not fasting plasma glucose (FPG) levels associated with the increased risk, according to a study published in the Sept. 20 issue of Neurology.

Tomoyuki Ohara, M.D., from Kyushu University in Fukuoka, Japan, and colleagues investigated the association between glucose tolerance status and the development of dementia among 1,107 individuals aged 60 years or older, who were free of dementia. The participants underwent oral glucose tolerance tests and were followed for 15 years.

The investigators found a significantly higher incidence of age- and sex-adjusted all-cause dementia, AD, and VaD in individuals with diabetes than in those with normal glucose tolerance. After adjusting for confounding factors, the associations remained strong for all-cause dementia (adjusted hazard ratio [HR], 1.74; 95 percent confidence interval [CI], 1.18 to 3.7) and AD (adjusted HR, 2.05; 95 percent CI, 1.18 to 3.57), but not for VaD (adjusted HR, 1.82; 95 percent CI, 0.89 to 3.71). Elevated PG levels significantly increased the risk of all-cause dementia, AD, and VaD even after covariate adjustments, but FPG levels were not similarly associated. Individuals with two-hour PG levels of 7.8 to 11.0 mmol/L or more had significantly higher multivariate adjusted HRs for all-cause dementia and AD than individuals with two-hour PG levels of less than 6.7 mmol/L. The risk of VaD was significantly higher in individuals with PG levels of 11.1 mmol/L or more.

"Our findings suggest that diabetes is a significant risk factor for all-cause dementia, AD, and probably VaD," the authors write.

One of the study authors disclosed financial ties to the pharmaceutical and medical device industries.

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