Department of Epidemiology, School of Public Health, Tianjin Medical University, Tianjin, China.
Age Ageing. 2013 May;42(3):398-400. doi: 10.1093/ageing/afs188. Epub 2013 Jan 7.
to investigate the prevalence and risk factors of diabetes to dementia and its subtypes such as Alzheimer disease (AD) and vascular dementia (VD) among the Chinese elderly population.
among 8,213 Chinese people aged 65 years and older, 1,109 subjects with type 2 diabetes millitus (T2DM) were ascertained by interview and direct glucose testing. All diabetic subjects were initially screened with the "DSM-IV criteria" for dementia and its subtypes. We compared the prevalence of dementia in diabetic patients with that in ordinary subjects, and analyzed the association of the status of diabetes with dementia including AD and VD. Logistic regression was used to assess OR of dementia and its subtypes with T2DM.
after a comprehensive geriatric and cognitive assessment, 132 diabetic subjects were diagnosed with all-cause dementia. The prevalence rate for dementia with T2DM was 1.61%. Of demented subjects, 37 subjects had AD, 30 subjects had VD. The prevalence rates for AD with T2DM and VD with T2DM were 4.51% and 3.65%, respectively. In the univariate analyses, among all diabetic subjects, compared with cognitive intactly subjects, the demented subjects, including AD and VD subjects, were older, more female had higher percentage of current smoking, had a greater duration of diabetes, took more frequent use of diabetes medications, and stronger effect of APOE ε4 status. In multivariate logistic regression analyses, variables including age, APOE ε4 allele, duration from onset of diabetes, using oral hypoglycemic agents, HMG-CoA reductase (statins) were significantly associated with increased risk for dementia with T2DM (all P < 0.05).
the present study shows that T2DM is associated with dementia and its subtypes amongst elderly people in the Chinese population.
调查中国老年人群中糖尿病对痴呆及其亚型（如阿尔茨海默病[AD]和血管性痴呆[VD]）的患病率和危险因素。
在 8213 名 65 岁及以上的中国人中，通过访谈和直接血糖检测确定了 1109 名 2 型糖尿病患者（T2DM）。所有糖尿病患者均采用“DSM-IV 标准”对痴呆及其亚型进行初步筛查。我们比较了糖尿病患者与普通人群痴呆的患病率，并分析了糖尿病状况与包括 AD 和 VD 在内的痴呆的关系。采用 logistic 回归评估 T2DM 与痴呆及其亚型的 OR。
经过全面的老年和认知评估，132 名糖尿病患者被诊断为所有原因的痴呆。T2DM 痴呆的患病率为 1.61%。在痴呆患者中，37 例患有 AD，30 例患有 VD。T2DM 合并 AD 和 T2DM 合并 VD 的患病率分别为 4.51%和 3.65%。在单因素分析中，与认知完整的受试者相比，所有糖尿病患者中，痴呆患者（包括 AD 和 VD 患者）年龄更大，女性更多，当前吸烟率更高，糖尿病病程更长，糖尿病药物使用更频繁，APOE ε4 状态的影响更强。在多变量 logistic 回归分析中，包括年龄、APOE ε4 等位基因、糖尿病发病时间、使用口服降糖药、羟甲基戊二酰辅酶 A 还原酶（他汀类药物）在内的变量与 T2DM 痴呆的风险增加显著相关（均 P<0.05）。
本研究表明，T2DM 与中国人群中老年人群的痴呆及其亚型有关。
