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Diabetes Care. 2016 Feb;39(2):300-7. doi: 10.2337/dc15-1588. Epub 2015 Dec 17.

Type 2 Diabetes as a Risk Factor for Dementia in Women Compared With Men: A Pooled Analysis of 2.3 Million People Comprising More Than 100,000 Cases of Dementia.

Author information

1
Alfred Health, Melbourne, Australia.
2
The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, U.K.
3
The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, U.K. The George Institute for Global Health, University of Sydney, Sydney, Australia Department of Epidemiology, Johns Hopkins University, Baltimore, MD.
4
Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, México.
5
Department of Epidemiology and Public Health, University College London, London, U.K. Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, U.K. Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, U.K.
6
Section of Care of the Elderly, Faculty of Medicine, Imperial College London, London, U.K.
7
Department of Biostatistics, Boston University School of Public Health, Boston, MA.
8
Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL.
9
Department of Medicine, University of Washington, Seattle, WA.
10
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA.
11
Department of Psychology, Gothenburg University, Gothenburg, Sweden.
12
Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC.
13
Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
14
Group Health Research Institute, Seattle, WA.
15
Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Tawian.
16
Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, Edinburgh, U.K. Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, U.K. Scottish Dementia Clinical Research Network, NHS Scotland, Edinburgh, U.K. Division of Psychiatry, The University of Edinburgh, Edinburgh, U.K.
17
Department of Neurology, Boston University School of Medicine, Boston, MA.
18
Norwegian Institute of Public Health, Oslo, Norway.
19
Aging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden School of Public Health, Tianjin Medical University, Tianjin, China.
20
The George Institute for Global Health, University of Sydney, Sydney, Australia School of Public Health, Curtin University, Perth, Australia rachel.huxley@curtin.edu.au.

Abstract

OBJECTIVE:

Type 2 diabetes confers a greater excess risk of cardiovascular disease in women than in men. Diabetes is also a risk factor for dementia, but whether the association is similar in women and men remains unknown. We performed a meta-analysis of unpublished data to estimate the sex-specific relationship between women and men with diabetes with incident dementia.

RESEARCH DESIGN AND METHODS:

A systematic search identified studies published prior to November 2014 that had reported on the prospective association between diabetes and dementia. Study authors contributed unpublished sex-specific relative risks (RRs) and 95% CIs on the association between diabetes and all dementia and its subtypes. Sex-specific RRs and the women-to-men ratio of RRs (RRRs) were pooled using random-effects meta-analyses.

RESULTS:

Study-level data from 14 studies, 2,310,330 individuals, and 102,174 dementia case patients were included. In multiple-adjusted analyses, diabetes was associated with a 60% increased risk of any dementia in both sexes (women: pooled RR 1.62 [95% CI 1.45-1.80]; men: pooled RR 1.58 [95% CI 1.38-1.81]). The diabetes-associated RRs for vascular dementia were 2.34 (95% CI 1.86-2.94) in women and 1.73 (95% CI 1.61-1.85) in men, and for nonvascular dementia, the RRs were 1.53 (95% CI 1.35-1.73) in women and 1.49 (95% CI 1.31-1.69) in men. Overall, women with diabetes had a 19% greater risk for the development of vascular dementia than men (multiple-adjusted RRR 1.19 [95% CI 1.08-1.30]; P < 0.001).

CONCLUSIONS:

Individuals with type 2 diabetes are at ∼60% greater risk for the development of dementia compared with those without diabetes. For vascular dementia, but not for nonvascular dementia, the additional risk is greater in women.

PMID:
26681727
PMCID:
PMC4722942
DOI:
10.2337/dc15-1588
[Indexed for MEDLINE]
Free PMC Article

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