Seo Da Hea, Kim Mina, Cho Yongin, Ahn Seong Hee, Hong Seongbin, Kim So Hun
Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon 22332, Republic of Korea.
Department of Data Science, Hanmi Pharmaceutical Company Limited, Seoul 05545, Republic of Korea.
J Clin Med. 2024 Jul 26;13(15):4386. doi: 10.3390/jcm13154386.
: Type 2 diabetes mellitus (T2DM) is a major contributor to cognitive decline and dementia in older adults; however, the role of the age of onset of T2DM in younger patients remains uncertain. We explored the association between the risk of dementia and its subtypes in relation to the age at T2DM diagnosis. This population cohort study included a total of 612,201 newly diagnosed T2DM patients. The controls were randomly selected from the general population and matched at a 1:2 ratio based on the propensity score. The outcomes of interest were all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VD). The association of T2DM with dementia was stratified by the age at diagnosis of T2DM. : The mean ages of the subjects in the T2DM and control groups were 55.7 ± 13.0 and 55.7 ± 13.0. The patients with T2DM diagnosed at <50 years had the highest excess risk for most outcomes relative to the controls, with a hazard ratio (HR) (95% CI) of 3.29 (3.11-3.49) for all-cause dementia, 4.08 (3.18-5.24) for AD, and 5.82 (3.84-8.81) for VD. All risks were attenuated progressively with each increasing decade at the diagnostic age, but remained significant; for T2DM diagnosed at ≥80 years, the HR (95% CI) was 1.38 (1.34-1.41) for all-cause dementia, 1.35 (1.31-1.40) for AD, and 1.98 (1.70-2.30) for VD. : We need to stratify T2DM management according to the age of diagnosis. Physicians should closely monitor cognitive function in patients with T2DM, especially in younger individuals.
2型糖尿病（T2DM）是导致老年人认知能力下降和痴呆的主要因素；然而，T2DM发病年龄在年轻患者中的作用仍不确定。我们探讨了T2DM诊断年龄与痴呆风险及其亚型之间的关联。这项人群队列研究共纳入612201例新诊断的T2DM患者。对照组从一般人群中随机选取，并根据倾向评分按1:2的比例进行匹配。感兴趣的结局为全因性痴呆、阿尔茨海默病（AD）和血管性痴呆（VD）。T2DM与痴呆的关联按T2DM诊断年龄进行分层。：T2DM组和对照组受试者的平均年龄分别为55.7±13.0岁和55.7±13.0岁。与对照组相比，在<50岁时诊断为T2DM的患者在大多数结局方面的额外风险最高，全因性痴呆的风险比（HR）（95%CI）为3.29（3.11 - 3.49），AD为4.08（3.18 - 5.24），VD为5.82（3.84 - 8.81）。随着诊断年龄每增加一个十年，所有风险逐渐减弱，但仍具有显著性；对于≥80岁时诊断为T2DM的患者，全因性痴呆的HR（95%CI）为1.38（1.34 - 1.41），AD为1.35（1.31 - 1.40），VD为1.98（1.70 - 2.30）。：我们需要根据诊断年龄对T2DM管理进行分层。医生应密切监测T2DM患者的认知功能，尤其是年轻患者。
