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Association of diabetes with stroke and post‐stroke dementia: A population‐based cohort study
Author(s) -
Shang Ying,
Fratiglioni Laura,
Marseglia Anna,
Plym Anna,
Welmer AnnaKarin,
Wang HuiXin,
Wang Rui,
Xu Weili
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.12101
Subject(s) - medicine , dementia , prediabetes , stroke (engine) , diabetes mellitus , cohort , hazard ratio , glycated hemoglobin , cohort study , population , confidence interval , type 2 diabetes , disease , endocrinology , mechanical engineering , environmental health , engineering
The impact of prediabetes and diabetes on stroke and the development of dementia after a stroke remain unclear. Methods A total of 2655 dementia‐free participants (including a stroke‐free cohort and a prevalent stroke cohort) were followed‐up for 12 years. Dementia and post‐stroke dementia were determined by clinical examinations and national registry data. Diabetes was ascertained via medical examination, medication use, medical records, or glycated hemoglobin (HbA1c) ≥6.5%. Prediabetes was defined as HbA1c ≥5.7% in diabetes‐free participants. Results In the stroke‐free cohort, 236 participants developed ischemic stroke, and 47 developed post‐stroke dementia. Diabetes was associated with ischemic stroke (hazard ratio [HR] 1.76, 95% confidence interval [CI] 1.16 to 2.67) and post‐stroke dementia (HR 2.56, 95% CI 1.04 to 6.25). In the prevalent stroke cohort, diabetes was also related to dementia risk. Prediabetes was not significantly related to stroke or post‐stroke dementia. Discussion Diabetes, but not prediabetes, is associated with an increased risk of ischemic stroke and post‐stroke dementia.