Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Stockholm Gerontology Research Center, Stockholm, Sweden.
Alzheimers Dement. 2021 Nov;17(11):1769-1778. doi: 10.1002/alz.12482. Epub 2021 Oct 12.
Diabetes is a well-established risk factor for dementia, but its impact on the prodromal phase of dementia is unclear.
Cohorts of older adults who were cognitively healthy (n = 1840) or had cognitive impairment-no dementia (CIND; n = 682) were followed over 12 years to detect incident CIND and dementia, respectively.
Poorly controlled diabetes (glycated hemoglobin [HbA1c] ≥7.5%; reference = normoglycemia) was associated with double the risk of CIND (Cox regression multi-adjusted hazard ratio [HR] 2.01, 95% confidence interval [CI] 1.13-3.58) and triple the risk CIND progressing to dementia (HR 2.87, 95% CI 1.20-6.85). Co-morbid diabetes and heart disease doubled the risk of incident CIND and dementia, although neither disease conferred a significant risk of either outcome alone. Elevated systemic inflammation contributed to the diabetes-associated increased dementia risk.
Diabetes characterized by poor glycemic control or cardiovascular complications is related to a greater risk of the development and progression of cognitive impairment. Inflammation may play a role in these relationships.
糖尿病是痴呆的一个既定危险因素，但它对痴呆前阶段的影响尚不清楚。
分别对认知健康的老年人队列（n=1840）或认知障碍但无痴呆（CIND；n=682）进行了 12 年的随访，以分别检测出 CIND 和痴呆的发病情况。
血糖控制不佳的糖尿病（糖化血红蛋白[HbA1c]≥7.5%；参考值=血糖正常）与 CIND 的风险增加一倍相关（Cox 回归多因素调整后的风险比[HR]2.01，95%置信区间[CI]1.13-3.58），且 CIND 进展为痴呆的风险增加两倍（HR 2.87，95%CI 1.20-6.85）。合并糖尿病和心脏病使 CIND 和痴呆的发病风险增加一倍，但这两种疾病本身都没有显著增加任何一种结果的风险。全身性炎症的升高可能与糖尿病相关的痴呆风险增加有关。
血糖控制不佳或伴有心血管并发症的糖尿病与认知障碍的发展和进展风险增加有关。炎症可能在这些关系中发挥作用。
