Department of Kinesiology, Central College, Pella, Iowa, USA.
Department of Dietetics and Nutrition, Kansas University Medical Center, Kansas City, Kansas, USA.
Eur J Neurol. 2024 Jul;31(7):e16294. doi: 10.1111/ene.16294. Epub 2024 Apr 2.
The prevalence of dementia is rapidly increasing. Attempts to further understand modifiable risk factors such as diabetes mellitus (DM) are urgently needed to inform public health policies for prevention. Thus, the objective of the current study was to assess the relationship between DM and risk of dementia and non-dementia mortality amongst women in the California Teachers Study prospective cohort.
Women (n = 124,509) aged 22-104 years at baseline were included. DM was ascertained from self-reported questionnaires and hospital-linked records. Dementia-related deaths were ascertained from state and national records. Competing risk regression models were used to estimate cause-specific hazard ratios and 95% confidence intervals for the association of DM with dementia- and non-dementia-related mortality.
There were 10,511 total DM cases and 3625 deaths due to dementia over a mean of 21.3 years of follow-up. Fully adjusted cause-specific hazard ratios of the association with DM were 2.26 (2.01, 2.55) for dementia-related and 1.97 (1.89, 2.05) for the competing risk of non-dementia-related mortality. This association was strongest amongst participants with incident DM, younger age at baseline and higher alcohol consumption or who were overweight.
In the California Teachers Study, women with DM had increased risk of mortality due to both dementia and non-dementia causes; however, the risk of mortality due to dementia was elevated compared to non-dementia causes only amongst participants with incident DM.
痴呆症的患病率正在迅速上升。为了制定公共卫生政策以进行预防，目前迫切需要进一步了解可改变的危险因素，如糖尿病（DM）。因此，本研究的目的是评估加利福尼亚教师研究前瞻性队列中女性的 DM 与痴呆症和非痴呆症死亡率之间的关系。
共纳入 124509 名基线时年龄为 22-104 岁的女性。DM 通过自我报告的问卷和与医院相关的记录确定。痴呆症相关死亡通过州和国家记录确定。使用竞争风险回归模型估计 DM 与痴呆症和非痴呆症相关死亡率之间的关联的特定原因风险比和 95%置信区间。
在平均 21.3 年的随访中，共有 10511 例 DM 总病例和 3625 例因痴呆症导致的死亡。经过完全调整的特定原因风险比显示，DM 与痴呆症相关的风险为 2.26（2.01，2.55），与非痴呆症相关的竞争风险为 1.97（1.89，2.05）。这种关联在新发生 DM 的参与者、基线年龄较小、饮酒量较高或超重的参与者中最强。
在加利福尼亚教师研究中，患有 DM 的女性死于痴呆症和非痴呆症的风险均增加；然而，仅在新发生 DM 的参与者中，痴呆症导致的死亡率风险高于非痴呆症原因。
