Alzheimer′s Disease and Type 2 Diabetes Mellitus: Risk Factors and Effectiveness of Antidiabetic Agents in Treatment of Alzheimer′s Disease

Myint, Aye Aye

doi:10.11648/j.sjcm.20130203.20

Cited by 3 publications

(1 citation statement)

References 95 publications

(84 reference statements)

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“…Similarly, non-black participants with memory complaints but without diabetes had over two-fold increased risk of dementia, while non-black participants with memory complaints but with diabetes had no increased risk. Although it has been shown that diabetes increases the risk of cerebrovascular pathology rather than Alzheimer’s disease pathology [29], use of hypoglycemic medications may decrease the risk of dementia [27], but the effects of different antidiabetic drugs may vary [28]. …”

Section: Discussionmentioning

confidence: 99%

Diabetes Mitigates the Role of Memory Complaint in Predicting Dementia Risk: Results From the Prevention of Alzheimer’s Disease With Vitamin E and Selenium Study

et al. 2017

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Background: Subjective memory complaints (SMCs) are associated with increased risk of dementia in older adults, but the role of comorbidities in modifying this risk is unknown. Objectives: To assess whether comorbidities modify estimated dementia risk based on SMCs. Design: The Prevention of Alzheimer’s Disease with Vitamin E and Selenium Study (PREADVISE) was designed as an ancillary study to the Selenium and Vitamin E Cancer Prevention Trial (SELECT), a randomized, multi-center prostate cancer prevention trial with sites in the Unites States, Puerto Rico, and Canada. In 2009, PREADVISE and SELECT were changed into cohort studies. Setting: Secondary analysis of PREADVISE data. Participants: PREADVISE recruited 7,540 non-demented male volunteers from participating SELECT sites from 2002 to 2009. SMCs, demographics, and comorbidities including hypertension, diabetes, coronary artery bypass graft (CABG), stroke, sleep apnea, and head injury were ascertained by participant interview. Measurements: Cox models were used to investigate whether baseline comorbidities modified hazard ratios (HR) for SMC-associated dementia risk using two methods: (1) we included one interaction term between SMC and a comorbidity in the model at a time, and (2) we included all two-way interactions between SMC and covariates of interest and reduced the model by “backward” selection. SMC was operationalized as any complaint vs. no complaint. Results: Baseline SMCs were common (23.6%). In the first analyses, with the exception of stroke, presence of self-reported comorbidities was associated with lower estimated HR for dementia based on SMC status (complaint vs. no complaint), but this difference was only significant for diabetes. In the second analysis, the two-way interactions between SMC and race as well as SMC and diabetes were significant. Here, black men without diabetes who reported SMC had the highest estimated dementia risk (HR=5.05, 95% CI 2.55-10.00), while non-black men with diabetes who reported SMC had the lowest estimated risk (HR=0.71, 95% CI 0.35-1.41). Conclusions: SMCs were more common among men with comorbidities, but these complaints appeared to be less predictive of dementia risk than those originating from men without comorbidities, suggesting that medical conditions such as diabetes may explain SMCs that are unrelated to an underlying neurodegenerative process.

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Section: Discussionmentioning

confidence: 99%

Diabetes Mitigates the Role of Memory Complaint in Predicting Dementia Risk: Results From the Prevention of Alzheimer’s Disease With Vitamin E and Selenium Study

et al. 2017

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Psychometric Extension of the Memory for Names Test

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Conversion of Mild Cognitive Impairment to Dementia among Subjects with Diabetes: A Population-Based Study of Incidence and Risk Factors with Five Years of Follow-up

Miao

et al. 2014

JAD

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Type 2 diabetes mellitus (T2DM) is associated with dementia. Mild cognitive impairment (MCI) is a key determinant in this association. It is not clear whether T2DM increases the risk of conversion from MCI to dementia. We plan to explore the relationship between T2DM-MCI and dementia and identify its potential risk factors. A prospective community-based cohort study was conducted from March 2010 to March 2014, including 634 participants with T2DM-MCI, 261 T2DM participants who were cognitively intact, and 585 MCI participants without diabetes. All cohort members received detailed annual evaluations to detect dementia onset during the 5 years of follow-up. The three cohorts were compared to assess differences in dementia onset. Furthermore, Cox proportional hazards regression was used to identify risk factors for dementia onset in the T2DM-MCI cohort. During follow-up, 152 and 49 subjects developed dementia in the MCI and cognitively-intact cohorts, amounting to an adjusted hazard ratio (HR) of 1.66 (95% CI 1.07-2.26). In a survival analysis of the cohorts, MCI accelerated the median progression to dementia by 2.74 years. In a multivariable analysis of the T2DM-MCI cohort, major risk factors for dementia were age >75 years and longer durations of diabetes, while significantly reduced risks of dementia were associated with oral hypoglycemic agents and HMG-CoA reductase inhibitors. Insulin was not associated with significantly changed risk. T2DM-MCI may aggravate the clinical picture as a concomitant factor. To minimize progression to dementia, it may be worthwhile to target several modifiable diabetes-specific features, such as the duration of disease, glycemic control, and antidiabetic agents.

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Alzheimer′s Disease and Type 2 Diabetes Mellitus: Risk Factors and Effectiveness of Antidiabetic Agents in Treatment of Alzheimer′s Disease

Cited by 3 publications

References 95 publications

Diabetes Mitigates the Role of Memory Complaint in Predicting Dementia Risk: Results From the Prevention of Alzheimer’s Disease With Vitamin E and Selenium Study

Diabetes Mitigates the Role of Memory Complaint in Predicting Dementia Risk: Results From the Prevention of Alzheimer’s Disease With Vitamin E and Selenium Study

Psychometric Extension of the Memory for Names Test

Conversion of Mild Cognitive Impairment to Dementia among Subjects with Diabetes: A Population-Based Study of Incidence and Risk Factors with Five Years of Follow-up

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