| アブストラクト | OBJECTIVE: Type 2 diabetes is an established risk factor for dementia. However, the roles of glycemic control and diabetic complications in the development of dementia have been less well substantiated. This large-scale cohort study aims to examine associations of longitudinal HbA1c levels and diabetic complications with the risk of dementia incidence among patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Data of eligible patients with diabetes, aged >/=50 years in the U.K. Clinical Practice Research Datalink from 1987 to 2018, were analyzed. Time-varying Cox regressions were used to estimate adjusted hazard ratios (HRs) and 95% CIs for dementia risk. RESULTS: Among 457,902 patients with diabetes, 28,627 (6.3%) incident dementia cases were observed during a median of 6 years' follow-up. Patients with recorded hypoglycemic events or microvascular complications were at higher risk of dementia incidence compared with those without such complications (HR 1.30 [95% CI 1.22-1.39] and 1.10 [1.06-1.14], respectively). The HbA1c level, modeled as a time-varying exposure, was associated with increased dementia risk (HR 1.08 [95% CI 1.07-1.09] per 1% HbA1c increment) among 372,287 patients with diabetes with postdiagnosis HbA1c records. Similarly, a higher coefficient of variation of HbA1c during the initial 3 years of follow-up was associated with higher subsequent dementia risk (HR 1.03 [95% CI 1.01-1.04] per 1-SD increment). CONCLUSIONS: Higher or unstable HbA1c levels and the presence of diabetic complications in patients with type 2 diabetes are associated with increased dementia risk. Effective management of glycemia might have a significant role in maintaining cognitive health among older adults with diabetes. |
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| 投稿日 | 2021/5/27 |
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| 投稿者 | Zheng, Bang; Su, Bowen; Price, Geraint; Tzoulaki, Ioanna; Ahmadi-Abhari, Sara; Middleton, Lefkos |
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| ジャーナル名 | Diabetes care |
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| 組織名 | Ageing Epidemiology Research Unit, School of Public Health, Imperial College;London, London, U.K.;Department of Epidemiology and Biostatistics, School of Public Health, Imperial;College London, London, U.K.;London, London, U.K. l.middleton@imperial.ac.uk.;Public Health Directorate, Imperial College Healthcare NHS Trust, London, U.K. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/34035076/ |
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