Severe Diabetes Associated With Higher Dementia Risk
Diabetes Complications Linked to Increased Dementia Risk
Diabetes patients with high rates of complications appear to be more likely to develop dementia later in life, new data published in the Journal of Clinical Endocrinology & Metabolism indicate.
Although studies have established a link between risk for dementia and diabetes, few have examined the relationship between the severity of diabetes and dementia risk, according to Wei-Che Chiu, MD, PhD, of the National Taiwan University College of Public Health, Cathay General Hospital and Fu Jen Catholic University in Taipei, Taiwan, and colleagues.
“Our research is the first nationwide study to examine how the severity and progression of diabetes is related to dementia diagnosis rates in an older population,” Chiu said in a press release. “We found that as diabetes progresses and an individual experiences more complications from the disease, the risk of dementia rises as well.”
Chiu and colleagues conducted a 12-year population-based cohort study using the Taiwan National Health Insurance Research Database's records dating back to 1999. They included 431,178 patients aged older than 50 years with new-onset diabetes in their evaluation. The researchers then tracked the number of patients who were admitted to the hospital or had at least three outpatient medical visits for dementia after receiving a diabetes diagnosis.
Diabetes progression was assessed using an adapted version of the Diabetes Complications Severity Index (DCSI).
Of all patients included in the study, 26,856 (6.2%) developed dementia, according to the study results.
After adjustment for patient factors, comorbidity, antidiabetes drugs and drug adherence, data delineated a link between scores and change in the adapted DSCI and the risk for dementia.
At the end of follow-up, for those with adapted DCSI scores of 1, 2, 3 and greater than 3, the adjusted HRs were 1.04 (95% CI, 0.99-1.09), 1.40 (95% CI, 1.34-1.46), 1.54 (95% CI, 1.47) and 1.70 (95% CI, 1.63-1.78; P<.001 for trend), respectively.
Additionally, results showed that, compared with mildly progressive patients (adapted DCSI score of less than 0.5 per year), the adjusted HRs increased as the adapted DCSI increased. Two-year HRs were 1.30, 1.53 and 1.97 and final HRs were 2.38, 6.95 and 24.0 with adapted DCSI scores per year of 0.51 to 1.00, 1.01 to 2.00 and 2.00 vs. 0.50 (P<.001 for trend).
Currently, diabetic complications are fairly common, according to the Endocrine Society's Endocrine Facts and Figures report. Among every 100 Americans diagnosed with diabetes, 21 have nerve damage, 27 have diabetic kidney disease and between 29 and 33 have diabetic eye disease.
“The study demonstrates why it is so crucial for people with diabetes to work closely with health care providers on controlling their blood sugar,” Chiu said. “Managing the disease can help prevent the onset of dementia later in life.”
Chiu W-C et al. Progress of Diabetic Severity and Risk of Dementia. J Clin Endocrinol Metab. 2015; doi:10.1210/jc.2015-1677.