Yashkin Arseniy P, Akushevich Igor, Ukraintseva Svetlana, Yashin Anatoliy
Duke University, Durham, NC, USA.
Gerontol Geriatr Med. 2018 Nov 13;4:2333721418811201. doi: 10.1177/2333721418811201. eCollection 2018 Jan-Dec.
The aim of this study was to examine the possibility that type 2 diabetes and Alzheimer's disease may share common behavioral protective factors such as adherence to type 2 diabetes treatment guidelines given that these two diseases have both epidemiological and metabolic similarities. : The method used in this study is a retrospective cohort study of 3,797 U.S. Medicare fee-for-service beneficiaries aged 66+ newly diagnosed with type 2 diabetes and without a prior record of Alzheimer's disease based on the Health and Retirement Study. : Results of a left-truncated Cox model showed that adherence reduces the risk of Alzheimer's disease by 20% to 24%. Other significant effects were college education (hazard ratio [HR]: 0.65; value: .023), stroke (HR: 1.40; value: .013), and 4+ limitations in physical functioning (HR: 1.33; value: .008). : Risk of Alzheimer's disease can be reduced by behavioral factors. Possible mechanisms may include earlier start of interventions to reduce blood glucose levels and improve insulin sensitivity.
鉴于2型糖尿病和阿尔茨海默病在流行病学和代谢方面存在相似性,本研究的目的是探讨这两种疾病是否可能共享共同的行为保护因素,如遵守2型糖尿病治疗指南。本研究采用的方法是对3797名66岁及以上新诊断为2型糖尿病且无阿尔茨海默病既往记录的美国医疗保险按服务收费受益人进行回顾性队列研究,该研究基于健康与退休研究。左截断Cox模型的结果显示,坚持治疗可将患阿尔茨海默病的风险降低20%至24%。其他显著影响因素包括大学教育(风险比[HR]:0.65;P值:0.023)、中风(HR:1.40;P值:0.013)以及身体功能存在4种及以上限制(HR:1.33;P值:0.008)。行为因素可降低患阿尔茨海默病的风险。可能的机制包括更早开始干预以降低血糖水平和提高胰岛素敏感性。