Younger age at diabetes diagnosis linked to higher risk for developing dementia
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Key takeaways:
- Adults diagnosed with diabetes at younger than 60 years have an increased risk for developing dementia.
- Those diagnosed with diabetes at age 80 years or older did not have a higher dementia risk.
Adults who are diagnosed with diabetes at a younger age have an increased risk for developing dementia, but researchers found no association between prediabetes and dementia risk, according to study data published in Diabetologia.
“We believe delaying prediabetes progression may potentially have a broad public health impact,” Michael Fang, PhD, assistant scientist in epidemiology at the Johns Hopkins Bloomberg School of Public Health, told Healio. “Prediabetes impacts 96 million adults in the U.S. and nearly 500 million adults worldwide. These numbers will continue to increase. Policies that effectively slow prediabetes progression may have an important impact on the overall burden of dementia.”
Fang and colleagues analyzed data from the Atherosclerosis Risk in Communities (ARIC) study. Data were collected from 11,656 adults who completed visit two from 1990 to 1992 (mean age, 56.8 years; 55.3% women). Prediabetes was defined as an HbA1c between 5.7% and 6.4%. Incident diabetes was determined through a self-reported diagnosis or diabetes medication use. Dementia was determined through an expert committee review of cognitive function assessments, informant reports and hospitalization codes. Demographics, lifestyle factors and clinical factors were collected at baseline. Follow-up continued until first diagnosis of dementia, death, loss to follow-up or the end of the study on Dec. 31, 2019.
Of the cohort, 20% had prediabetes at baseline. There were 3,143 adults who developed diabetes during a median 15.9 years of follow-up. A higher percentage of adults with prediabetes developed diabetes than those without prediabetes (44.6% vs. 22.5%).
Of the cohort, 2,247 adults developed dementia during a median 24.7 years of follow-up. The proportion of adults who developed dementia was higher among those with diabetes vs. those without diabetes (23.9% vs. 20.5%).
After adjusting for incident diabetes and other covariates, researchers found no association between prediabetes and dementia. In multivariable models, adults who developed diabetes at younger than 60 years had a higher risk for dementia than those without diabetes (adjusted HR = 2.92; 95% CI, 2.06-4.14). The risk for dementia among adults who developed diabetes at age 60 to 69 years (aHR = 1.73; 95% CI, 1.47-2.04) and age 70 to 79 years (aHR = 1.23; 95% CI, 1.08-1.4) was also higher than those without diabetes. Adults who developed diabetes at age 80 years or older did not have an increased risk for dementia.
Fang said the findings reveal the importance of slowing or preventing prediabetes progression to diabetes, especially for younger adults.
“Providers can help patients slow and prevent prediabetes progression through modest weight loss,” Fang said. “Referring patients to structured lifetime programs may be especially effective. The government has created a federal program called the National Diabetes Prevention Program specifically aimed at preventing diabetes at a national level. However, less than 5% of U.S. adults with prediabetes are referred to these programs by their providers.”
Fang said more research is needed to understand how to effectively implement successful diabetes prevention policies and programs.
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