2023-05-31 02:40:08
The earlier a patient slips from prediabetes to type 2 diabetes, the higher their risk of developing dementia. These current results show once again how important prevention is.
New research resultsin the Diabetes have been published show a connection between Typ-2-Diabetes (T2D) and the development of dementia later in life – the risk of dementia increases the earlier a person develops T2D. In the study, graduate student Jiaqi Hu and Prof. Elizabeth Selvin from the Johns Hopkins Bloomberg School of Public Health and colleagues examined the link between prediabetes and dementia. In people with prediabetes, the risk of progression to T2D is significant; in middle-aged adults with prediabetes, 5-10% per year will develop T2D, with a total of 70% of people with prediabetes developing T2D in their lifetime. In the US, up to 96 million adults have prediabetes, which is 38% of the adult population.
From prediabetes to type 2: when it tips
To understand the risk of dementia associated with prediabetes, the authors analyzed data from participants in the Atherosclerosis Risk in Communities (ARIC) study. Participants ranged in age from 45 to 64 during the period 1987-1989 and came from four US counties: Forsyth County, North Carolina; Jackson, Mississippi; suburbs of Minneapolis, Minnesota; and Washington County, Maryland. The baseline for the analysis was visit 2 of the study (1990-1992), during which the HbA1c value and cognitive functions were measured in this study. The analysis incorporated data from a scoring system that included three cognitive tests administered at visits 2 (1990-1992) and 4 (1996-1998) and the expanded neuropsychological ten-test suite administered from visit 5 (2011 –2013) and survey of informants (Clinical Dementia Rating Scale (CDR) and Functional Activities Questionnaire, FAQ). The Mini-Mental State Examination (MMSE) was also conducted. The participants were followed up until 2019.
The authors defined prediabetes as an HbA1c of 39–46 mmol/mol (5.7–6.4%). They also examined subsequent diagnoses of T2D during follow-up. The authors assessed the association between prediabetes and risk of dementia before and after accounting for the later development of T2D in the ARIC participants with prediabetes at baseline. This was done to understand how much of the link between prediabetes and dementia was explained by progression to diabetes. They also looked at whether age at diagnosis of diabetes altered risk of dementia.
Dementia risk and diabetes age
Of the 11,656 participants who did not have diabetes at baseline, 2,330 (20%) had pre-diabetes. Taking into account diabetes that developed after the baseline period, the authors found no statistically significant association between prediabetes and dementia. However, they found that earlier age at developing T2D had the strongest association with dementia – a three-fold increased risk of dementia for those who develop T2D before age 60, decreasing to a 73% increased risk for those who did develop T2D by age 60-69 and a 23% increased risk for those who develop T2D by age 70-79. At age 80 or older, developing T2D was not associated with an increased risk of dementia.
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The authors conclude: “Prediabetes is associated with a risk of dementia, but this risk is explained by the development of diabetes. The onset of diabetes at a young age is most strongly associated with dementia. Preventing or delaying the progression from prediabetes to diabetes will therefore significantly reduce the future burden of dementia.”
This article is based on a press release in diabetology. We have the study for you here and linked in the text.
Image source: DL Samuels, Unsplash
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