4.5 Article

Diabetes-Associated Dementia Risk and Competing Risk of Death in the Three-City Study

Journal

JOURNAL OF ALZHEIMERS DISEASE
Volume 71, Issue 4, Pages 1339-1350

Publisher

IOS PRESS
DOI: 10.3233/JAD-190427

Keywords

Cohort studies; death; dementia; type 2 diabetes mellitus

Categories

Funding

  1. Caisse Nationale Maladie des Travailleurs Salaries
  2. Direction Generale de la Sante
  3. Mutuelle Generale de l'Education Nationale
  4. Institut de la Longevite
  5. Conseil Regionaux of Aquitaine
  6. Conseil Regionaux of Bourgogne
  7. Fondation de France
  8. Ministry of Research-INSERM Programme Cohortes et collections de donnees biologiques
  9. Fondation Plan Alzheimer (FCS 2009-2012)
  10. Caisse Nationale pour la Solidarit'e et l'Autonomie
  11. Agence Nationale de la Recherche ANR PNR 2006 [ANR/DEDD/PNRA/PROJ/200206-01-01]
  12. Longvie 2007 [LVIE-003-01]
  13. Fondation pour la Recherche Medicale

Ask authors/readers for more resources

Diabetes is associated with a higher dementia and mortality risk. However, few studies have accounted for death when estimating the association between diabetes and dementia. We estimated absolute and relative risks of all-cause dementia according to diabetes exposure status in older adults while accounting for competing risk of death using illness-death models. Effect modification by specific characteristics (age, gender, education, cardiovascular risk factors, body mass index, cardiovascular history, depressive symptomatology, impaired renal function, and APOE epsilon 4 genotype) was also investigated. We analyzed the Three-City study data, a French population-based cohort of adults aged 65 years and above who were followed up for 12 years from 1999-2001. Among 8,328 participants selected in the analytical sample (median age, 73.3 years; 60.3% women), 809 (9.3%) presented with diabetes at baseline. Over a median follow-up period of 8.3 years, 836 participants developed incident dementia. Baseline diabetes was associated with a higher risk of dementia: hazard ratio, 1.79 [95% confidence interval, 1.46-2.19]. No effect modification was shown. Diabetes was associated with a higher 12-year absolute risk of dementia and a lower dementia-free life expectancy (e.g., 14.5% [11.2-18.1] versus 8.7% [7.6-10.2], and 13.4 [12.7-14.1] years versus 16.5 [16.0-17.1] years, respectively, for a 70-year-old woman with the highest level of education). These findings support the potential impact of preventing diabetes on reducing dementia risk in older adults, with a 2-3-year higher dementia-free life expectancy for individuals without diabetes, and inform the design of future interventional trials.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.5
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available