Dr. Yen's Clinic, Gueishan District, Taoyuan, Taiwan.
Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung City, Taiwan.
J Alzheimers Dis. 2022;89(1):323-333. doi: 10.3233/JAD-220207.
Type 2 diabetes (T2D) and hypertension (HTN) are well-known modifiable risk factors for dementia, but their intricate attributes accounting for dementia development has not been clearly delineated.
We conducted this study to investigate and compare the effects of T2D and HTN on dementia risk.
We screened data of matched pairs of patients with T2D or HTN between January 1, 2000 and December 31, 2017 from Taiwan's National Health Insurance Research Database. Fine and Gray's subdistribution hazard models were used for calculating the risk of dementia.
Patients with T2D and subsequent HTN were associated with significantly higher risks of all-cause dementia (aHR 1.51, 95% CI 1.25-1.83) and vascular dementia (aHR 2.30, 95% CI 1.71-3.13) compared with those without subsequent HTN. Patients with HTN and subsequent T2D were associated with significantly higher risks of all-cause dementia (aHR 1.15, 95% CI 1.08-1.21), vascular dementia (aHR 1.25, 95% CI 1.62-1.34), and other dementia (aHR 1.31, 95% CI 1.03-1.66) compared with those without subsequent HTN. The subgroups of male and female patients, age of 50-69 and 70-90 years with subsequent comorbidity were associated with significantly higher risks of all-cause dementia and vascular dementia than those without subsequent comorbidity.
This nationwide cohort study demonstrated that patients with T2D and subsequent HTN had association with higher risks of all-cause dementia and vascular dementia, and those with HTN and subsequent T2D were associated with higher risks of all-cause dementia, vascular dementia, and other dementia.
2 型糖尿病（T2D）和高血压（HTN）是众所周知的可改变的痴呆风险因素，但它们对痴呆发展的复杂影响尚未明确界定。
我们进行这项研究旨在调查和比较 T2D 和 HTN 对痴呆风险的影响。
我们从台湾全民健康保险研究数据库中筛选了 2000 年 1 月 1 日至 2017 年 12 月 31 日期间患有 T2D 或 HTN 的患者的配对数据。Fine 和 Gray 的亚分布风险模型用于计算痴呆风险。
与无后续 HTN 的患者相比，患有 T2D 且随后患有 HTN 的患者患所有原因痴呆（aHR 1.51，95%CI 1.25-1.83）和血管性痴呆（aHR 2.30，95%CI 1.71-3.13）的风险显著更高。患有 HTN 且随后患有 T2D 的患者患所有原因痴呆（aHR 1.15，95%CI 1.08-1.21）、血管性痴呆（aHR 1.25，95%CI 1.62-1.34）和其他痴呆（aHR 1.31，95%CI 1.03-1.66）的风险显著更高与无后续 HTN 的患者相比。男性和女性患者亚组、年龄在 50-69 岁和 70-90 岁且有后续合并症的患者与无后续合并症的患者相比，患所有原因痴呆和血管性痴呆的风险显著更高。
这项全国性队列研究表明，患有 T2D 且随后患有 HTN 的患者患所有原因痴呆和血管性痴呆的风险较高，而患有 HTN 且随后患有 T2D 的患者患所有原因痴呆、血管性痴呆和其他痴呆的风险较高。
