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O2‐10‐04: Type 2 diabetes and risk of dementia and cognitive impairment without dementia among older Mexican‐Americans
Author(s) -
Mayeda Elizabeth,
Neuhaus John,
Yaffe Kristine,
Kanaya Alka,
Haan Mary
Publication year - 2012
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 - 10.1016/j.jalz.2012.05.681
Subject(s) - dementia , hazard ratio , medicine , proportional hazards model , population , gerontology , type 2 diabetes mellitus , demography , confidence interval , diabetes mellitus , disease , environmental health , sociology , endocrinology
Background: Conceivably, hypoglycemia may contribute to diabetes-related cognitive impairment; yet, the few investigations of hypoglycemia and cognitive function have had inconsistent findings.We sought to evaluate the presence and form of association between hypoglycemia and dementia in older adults with diabetes. Methods: In 913 diabetic older adults (mean age 74.1 years; 52% black; 48% female) participating in the Health ABC study free of dementia at baseline, we ascertained hypoglycemic events using hospital records indicating a hospital visit associated with hypoglycemia. Dementia diagnosis was determined by hospital records or use of prescribed dementia medications. We used Cox-proportional hazard regression models to estimate the association between time to a dementia diagnosis following a hypoglycemic event as well as the association between time to a hypoglycemic event following a dementia diagnosis. Models were adjusted for age, race, sex, and education.Results:Over 12 years of follow-up, 77 (8.4%) participants experienced a hypoglycemic event and 178 (19.4%) older adults with diabetes developed dementia. Compared to those without a hypoglycemic event, participants who experienced a hypoglycemic event had a two-fold increased risk of a dementia (18.2% vs. 33.8%; unadjusted HR 1⁄4 2.0; 95% CI 1.13, 3.53). Similarly, older adults with diabetes who were diagnosed with dementia had a greater risk of experiencing a hypoglycemic event than participants without dementia (14.6% vs. 6.9%; HR 1.96; 95% CI 0.98, 3.90). Adjusting for age, race, sex, and education produced similar results. Conclusions: Among older adults with diabetes there appears to be a reciprocal association between dementia and hypoglycemia. This suggests that elders with diabetesmay be particularly vulnerable to a vicious cycle of compromised disease management leading to cognitive impairment and further risk of poor disease management.