Relationship Between Fasting Blood Glucose Levels in Middle Age and Cognitive Function in Later Life: The Aichi Workers’ Cohort Study

Shimoda, Masako; Kaneko, Kayo; Nakagawa, Toshio; Kawano, Naoki; Otsuka, Rei; Ota, Atsuhiko; Naito, Hisao; Matsunaga, Masaaki; Ichino, Naohiro; Yamada, Hiroya; Chiang, Chifa; Hirakawa, Yoshihisa; Koji, Takehiko; Aoyama, Atsuko; Yatsuya, Hiroshi

doi:10.2188/jea.je20210128

Cited by 6 publications

(4 citation statements)

References 36 publications

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“…4,5 A limitation of these studies is that they have not addressed the impact of comorbidities like diabetes at the time of a dementia diagnosis. Diabetes is a risk factor for cognitive decline and dementia, [6][7][8] including in people aged ≥80 years. 9 Older individuals with dementia may be more prone to hyperglycemia and hypoglycemia, mainly because cognitive and physical decline can interfere with medication adherence.…”

Section: Introductionmentioning

confidence: 99%

Impact of diabetes on mortality and hospitalization after dementia diagnosis: Health insurance claims data analysis

Matsunaga,

Tanihara,

et al. 2024

Geriatrics Gerontology Int

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AimJapan faces a public health challenge of dementia, further complicated by the increasing complications from diabetes within its rapidly aging population. This study assesses the impact of diabetes on mortality and hospitalization among individuals aged ≥75 years with new dementia diagnoses.MethodsWe analyzed administrative claims data in Japan from 73 324 individuals aged ≥75 years with dementia, of whom 17% had comorbid diabetes. Dementia and diabetes were identified from the International Classification of Diseases, Tenth Revision codes. We used Kaplan–Meier survival analysis, Cox proportional hazards analysis, and population attributable fractions (PAFs) to evaluate the impact on mortality and hospitalization after dementia diagnosis.ResultsOne‐year mortality and 1‐year hospitalization probabilities in individuals with dementia and diabetes (10.3% and 31.7%, respectively) were higher than those without diabetes (8.3% and 25.4%, respectively). The adjusted hazard ratios for individuals with diabetes, as compared to those without, were 1.126 (95% confidence interval [CI], 1.040–1.220) for mortality and 1.191 (95% CI, 1.140–1.245) for hospitalization. The PAFs from the comorbidity of dementia and diabetes were 2.2% for mortality and 3.1% for hospitalization. Subgroup analysis showed that the PAFs were highest in men aged 75–79 years and women aged 80–84 years for mortality and in individuals aged 75–79 for hospitalization.ConclusionDuring the early postdiagnosis period, comorbid diabetes increases mortality and hospitalization risks in older adults with dementia. The variation in disease burden across age groups underscores the need for age‐specific health care strategies to manage comorbid diabetes in individuals with dementia. Geriatr Gerontol Int 2024; ••: ••–••.

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Section: Introductionmentioning

confidence: 99%

Impact of diabetes on mortality and hospitalization after dementia diagnosis: Health insurance claims data analysis

Matsunaga,

Tanihara,

et al. 2024

Geriatrics Gerontology Int

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“…DM itself increases the risk of cognitive decline. 13 In Japan, the PLWD receives care from family members and often from long-term care service institutions following the instructions of geriatric physicians or clinicians. There is also a provision of a 'Community-based integrated care system' that has been promoted by the government since 2015.…”

Section: Introductionmentioning

confidence: 99%

“…As we mentioned earlier, appropriate diabetes care for older people with or without dementia would be important to make them active, functioning, and achieving well‐being. DM itself increases the risk of cognitive decline 13 . In Japan, the PLWD receives care from family members and often from long‐term care service institutions following the instructions of geriatric physicians or clinicians.…”

Section: Introductionmentioning

confidence: 99%

Diabetes management in people living with dementia in Japan: a qualitative exploration

et al. 2022

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Background: Dementia and diabetes are highly prevalent among the older society in Japan. People living with dementia (PLWD) often face hurdles in managing diabetes. This study explored the perspectives of healthcare providers in Japan regarding diabetes management in PLWD. Methods: We conducted a qualitative study using in-depth interviews as a data collection method. A total of 15 physicians and nurses were interviewed. A qualitative content analysis of the codes was performed to generate the themes. Results: The major themes focused on the management of medications/ therapeutic regimen, difficulties of continuing health care, emotional aspects of PLWD for adherence to lifestyle modification, and varying direction and degree of family support for diabetes care. Conclusion: PLWD in Japan face challenges in medication management, food restriction, and lifestyle modification. Policies to engage home visit care workers in medication management, consideration of the emotional aspect of PLWD, and utilisation of social support might help in the proper management of diabetes in PLWD.

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“…On the other hands, there are studies showed the opposite ndings. Shimoda et al demonstrated, with the same MoCA measurement, that subjects with diabetes had higher odds ratio to have a MoCA score ≤ 25 (3.2)[37]. However, they did not use linear regression which could quantify the effects of glucose on the MoCA.…”

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confidence: 99%

The comparison between multiple linear regression and machine learning methods in predicting cognitive function in Chinese type 2 diabetes

Liu

Peng

Huang

et al. 2023

Preprint

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The prevalence of type 2 diabetes (T2D) has been increasing drastically in recent decades. In the same time, it has been noted that dementia is related to T2D. In the past, traditional multiple linear regression (MLR) is the most commonly used method in analyzing these kinds of relationships. However, machine learning methods (Mach-L) have been emerged recently. These methods could capture non-linear relationships better than the MLR. In the present study, we enrolled old T2D and used four different Mach-L methods to analyze the relationships between risk factors and cognitive function. Our goals were first, to compare the accuracy between MLR and Mach-L in predicting cognitive function and second, to rank importance of the risks for impaired cognitive function in T2D. There were 197 old T2D enrolled (98 men and 99 women). Demographic and biochemistry data were used as independent variables and the cognitive function assessment (CFA) score was measured by Montreal Cognitive Assessment which was regarded as independent variable. In addition to traditional MLR, random forest (RF), stochastic gradient boosting (SGB), Naïve Byer’s classifier (NB) and eXtreme gradient boosting (XGBoost) were also applied. Our results showed that all the RF, SGB, NB and XGBoost outperformed than the MLR. Education level, age, frailty score, fasting plasma glucose and body mass index were identified as the important factors from the more to the less important. In conclusion, our study demonstrated that RF, SGB, NB and XGBoost are more accurate than the MLR and in predicting CFA score. By these methods, the importance ranks of the risk factors are education level, age, frailty score, fasting plasma glucose and body mass index accordingly in a Chinese T2D cohort.

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Relationship Between Fasting Blood Glucose Levels in Middle Age and Cognitive Function in Later Life: The Aichi Workers’ Cohort Study

Abstract: This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record.

Cited by 6 publications

References 36 publications

Impact of diabetes on mortality and hospitalization after dementia diagnosis: Health insurance claims data analysis

Impact of diabetes on mortality and hospitalization after dementia diagnosis: Health insurance claims data analysis

Diabetes management in people living with dementia in Japan: a qualitative exploration

The comparison between multiple linear regression and machine learning methods in predicting cognitive function in Chinese type 2 diabetes

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