TY - JOUR
T1 - Incidence and risk factors for dementia in type 2 diabetes mellitus
T2 - A nationwide population-based study in Korea
AU - Yu, Ji Hee
AU - Han, Kyungdo
AU - Park, Sanghyun
AU - Cho, Hanna
AU - Lee, Da Young
AU - Kim, Jin Wook
AU - Seo, Ji A.
AU - Kim, Sin Gon
AU - Baik, Sei Hyun
AU - Park, Yong Gyu
AU - Choi, Kyung Mook
AU - Kim, Seon Mee
AU - Kim, Nan Hee
N1 - Publisher Copyright:
Copyright © 2020 Korean Diabetes Association
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Background: Diabetes mellitus is associated with an increased risk of dementia. We aimed to comprehensively analyze the incidence and risk factors for dementia and young-onset dementia (YOD) in diabetic patients in Korea using the National Health Insurance Service data. Methods: Between January 1, 2009 and December 31, 2012, a total of 1,917,702 participants with diabetes were included and followed until the date of dementia diagnosis or until December 31, 2015. We evaluated the incidence and risk factors for all dementia, Alzheimer's disease (AD), and vascular dementia (VaD) by Cox proportional hazards analyses. We also compared the impact of risk factors on the occurrence of YOD and late-onset dementia (LOD). Results: During an average of 5.1 years of follow-up, the incidence of all types of dementia, AD, or VaD was 9.5, 6.8, and 1.3/1,000 person-years, respectively, in participants with diabetes. YOD comprised 4.8% of all dementia occurrence, and the ratio of AD/ VaD was 2.1 for YOD compared with 5.5 for LOD. Current smokers and subjects with lower income, plasma glucose levels, body mass index (BMI), and subjects with hypertension, dyslipidemia, vascular complications, depression, and insulin treatment developed dementia more frequently. Vascular risk factors such as smoking, hypertension, and previous cardiovascular diseases were more strongly associated with the development of VaD than AD. Low BMI and a history of stroke or depression had a stronger influence on the development of YOD than LOD. Conclusion: The optimal management of modifiable risk factors may be important for preventing dementia in subjects with diabetes mellitus.
AB - Background: Diabetes mellitus is associated with an increased risk of dementia. We aimed to comprehensively analyze the incidence and risk factors for dementia and young-onset dementia (YOD) in diabetic patients in Korea using the National Health Insurance Service data. Methods: Between January 1, 2009 and December 31, 2012, a total of 1,917,702 participants with diabetes were included and followed until the date of dementia diagnosis or until December 31, 2015. We evaluated the incidence and risk factors for all dementia, Alzheimer's disease (AD), and vascular dementia (VaD) by Cox proportional hazards analyses. We also compared the impact of risk factors on the occurrence of YOD and late-onset dementia (LOD). Results: During an average of 5.1 years of follow-up, the incidence of all types of dementia, AD, or VaD was 9.5, 6.8, and 1.3/1,000 person-years, respectively, in participants with diabetes. YOD comprised 4.8% of all dementia occurrence, and the ratio of AD/ VaD was 2.1 for YOD compared with 5.5 for LOD. Current smokers and subjects with lower income, plasma glucose levels, body mass index (BMI), and subjects with hypertension, dyslipidemia, vascular complications, depression, and insulin treatment developed dementia more frequently. Vascular risk factors such as smoking, hypertension, and previous cardiovascular diseases were more strongly associated with the development of VaD than AD. Low BMI and a history of stroke or depression had a stronger influence on the development of YOD than LOD. Conclusion: The optimal management of modifiable risk factors may be important for preventing dementia in subjects with diabetes mellitus.
KW - Alzheimer disease
KW - Dementia
KW - Dementia
KW - Diabetes mellitus
KW - Risk factors
KW - Type 2
KW - Vascular
UR - http://www.scopus.com/inward/record.url?scp=85080947387&partnerID=8YFLogxK
U2 - 10.4093/dmj.2018.0216
DO - 10.4093/dmj.2018.0216
M3 - Article
C2 - 31769236
AN - SCOPUS:85080947387
SN - 2233-6079
VL - 44
SP - 113
EP - 124
JO - Diabetes and Metabolism Journal
JF - Diabetes and Metabolism Journal
IS - 1
ER -