BACKGROUND: While not definitive, many studies demonstrate a link between type 2 diabetes mellitus (DM) and a higher risk of all-cause dementia and Alzheimer’s disease (AD). This study aims to compare the risk of developing all-cause dementia or AD in subjects with a history of controlled versus uncontrolled DM.
METHODS: Framingham Heart Study (FHS) Offspring Cohort participants that were without dementia and at least 45 years old when they attended the 7th biennial examination (n = 2978 persons) were included in this prospective community-based cohort study. Subjects were designated a history of controlled DM if they had a positive history of DM and fasting blood glucose (FBG) less than 140 mg/dL. Subjects were designated a history of uncontrolled DM if they had a positive history of DM and FBG greater than or equal to 140 mg/dL. All-cause dementia was determined through criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). AD was determined through criteria from the National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS/ADRDA). Models were adjusted for age, self-reported sex, education and cardiovascular risk factors.
RESULTS: At baseline, 333 participants (11.2%) were positive for ‘current diabetes.’ In the 20-year follow-up period, 12.2% of uncontrolled DM subjects, 11.2% of controlled DM subjects, and 6.4% of normal control (NC) subjects developed all-cause dementia. Relative risk for all-cause dementia with controlled DM was 1.62 (95% confidence interval, 0.900 - 2.93). Relative risk for all-cause dementia with uncontrolled DM was 1.72 (95% confidence interval, 1.02 - 2.89). 11% of uncontrolled DM subjects, 7.9% of controlled DM subjects, and 4.7% of NC subjects eventually acquired AD. The relative risk for AD with controlled DM was 1.76 (95% confidence interval, 0.890 – 3.47). Relative risk for AD with uncontrolled DM was 2.15 (95% confidence interval, 1.22 - 3.80).
CONCLUSION: In the FHS Offspring Cohort, subjects with uncontrolled DM were at higher risk of developing all-cause dementia and AD compared to controlled DM and NC participants. The controlled DM status was not found to be a risk factor for all-cause dementia or AD.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/44001 |
| Date | 09 March 2022 |
| Creators | Huang, Matthew |
| Contributors | Au, Rhoda, Trinkaus-Randall, Vickery |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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