Diabetes in a Large Dementia Cohort: Clinical Characteristics and Treatment From the Swedish Dementia Registry

Abstract

OBJECTIVEWe aimed to investigate the differences in clinical characteristics and pharmacological treatment associated with the presence of diabetes in a large cohort of patients with dementia.RESEARCH DESIGN AND METHODSA cross-sectional registry-based study was conducted using data from the Swedish Dementia Registry (SveDem). Data on dementia diagnosis, dementia type, and demographic determinants were extracted from SveDem. Data from the Swedish Patient Register and Prescribed Drug Register were combined for the diagnosis of diabetes. Data on antidiabetic, dementia, cardiovascular, and psychotropic medications were extracted from the Swedish Prescribed Drug Register. Logistic regression was used to determine whether the variables were associated with diabetes after adjustment for confounders. In total, 29,630 patients were included in the study, and 4,881 (16.5%) of them received a diagnosis of diabetes.RESULTSIn the fully adjusted model, diabetes was associated with lower age at dementia diagnosis (odds ratio [OR] 0.97 [99% CI 0.97–0.98]), male sex (1.41 [1.27–1.55]), vascular dementia (1.17 [1.01–1.36]), and mixed dementia (1.21 [1.06–1.39]). Dementia with Lewy bodies (0.64 [0.44–0.94]), Parkinson disease dementia (0.46 [0.28–0.75]), and treatment with antidepressants (0.85 [0.77–0.95]) were less common among patients with diabetes. Patients with diabetes who had Alzheimer disease obtained significantly less treatment with cholinesterase inhibitors (0.78 [0.63–0.95]) and memantine (0.68 [0.54–0.85]).CONCLUSIONSPatients with diabetes were younger at dementia diagnosis and obtained less dementia medication for Alzheimer disease, suggesting less optimal dementia treatment. Future research should evaluate survival and differences in metabolic profile in patients with diabetes and different dementia disorders.

Mental disorders and medical comorbidities: Association rule mining approach

“…Studies have revealed that individuals with dementia were more likely to be diagnosed with diabetes . Another study indicated that diabetes was associated with a lower age of dementia diagnosis, suggesting the need for optimal dementia treatment . Furthermore, patients with dementia exhibited a higher risk of circulatory system diseases (Table ); the rule “circulatory system→dementia” also represented the association between circulatory diseases and dementia.…”

“…5,28 Another study indicated that diabetes was associated with a lower age of dementia diagnosis, suggesting the need for optimal dementia treatment. 29 Furthermore, patients with dementia exhibited a higher risk of circulatory system diseases (Table 3); the rule "circulatory system→dementia" also represented the association between circulatory diseases and dementia. The study revealed that stroke, atherosclerosis, and hypertension were frequent comorbidities among patients with dementia.…”

Socioeconomic position in childhood and cognitive aging in Europe

“…Information on clinical and social risk factors, as potential mediators in the association of SEP with cognition, was initially identified based on the literature [24][25][26][27][28][29][30] and availability in the SHARE dataset. From those, we chose variables that were associated with the composite cognitive score at the level of p < 0.05 in at least 4 waves, after adjustment for age, sex, and years of education.…”

Hypoglycemia and the risk of cognitive impairment and dementia in elderly and senile patients with type 2 diabetes

“…Haroon et al [23] выявлено, что у пациентов с недавно диагностированным СД2 риск деменции составлял 1,16 (95% ДИ 1,15-1,18) [23] по сравнению с больными без СД. Установлено также, что деменция у пациентов с СД развивается в более молодом возрасте и чаще имеет сосудистый генез по сравнению с лицами без СД [24]. В свою очередь, КН снижают способность больных СД к адекватному контролю гипергликемии и увеличивают риск развития осложнений.…”