Kim Jonguk, Han Kyung-Do, Lee Jeong-Yoon, Yang Ye Seul, Cheon Dae Young, Lee Jae-Jun, Lee Minwoo
Departments of Neurology, Inha University Hospital, Incheon, Korea.
Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
Alzheimers Res Ther. 2025 Mar 8;17(1):58. doi: 10.1186/s13195-025-01708-8.
The influence of duration of type 2 diabetes mellitus (T2DM) on the likelihood of developing new-onset dementia in post-stroke population is not well understood. Therefore, we aimed to clarify the relationship between the duration of T2DM and the risk of developing dementia in the post-stroke population.
Leveraging the Korean National Health Insurance Database, this study included 118,790 individuals with a history of stroke but no previous dementia diagnosis. We classified diabetes status into five categories: normoglycemia, impaired fasting glucose (IFG), newly diagnosed T2DM, and established T2DM with durations of less than 5 years and 5 years or more. The primary endpoint was the incidence of all-cause dementia.
Among 118,790 participants (average age 64.26 ± 9.95 years, 48% male), 16.7% developed dementia during an average follow-up of 7.3 ± 2.3 years. Participants with a history of T2DM for less than five years at cohort entry had a 26.7% higher risk of developing all-cause dementia compared to those with normoglycemia. Those with T2DM for five years or longer had a 46.7% increased risk, with an adjusted hazard ratio (aHR) of 1.466 (95% confidence interval [CI], 1.408-1.527). Specifically, the risk of developing Alzheimer's disease (AD) and vascular dementia (VaD) rose by 43.4% and 51.4%, respectively, for individuals with T2DM lasting more than five years (aHR 1.434, 95% CI 1.366-1.505; aHR 1.514, 95% CI 1.365-1.679, respectively).
Our findings demonstrated a significant association between an extended duration of T2DM and an increased risk of developing all-cause dementia, including AD and VaD in post-stroke population. These results emphasize proactive dementia prevention approaches in stroke survivors, particularly those with longstanding T2DM.
2型糖尿病（T2DM）病程对中风后人群发生新发痴呆症可能性的影响尚不清楚。因此，我们旨在阐明T2DM病程与中风后人群发生痴呆症风险之间的关系。
利用韩国国民健康保险数据库，本研究纳入了118790名有中风病史但既往无痴呆症诊断的个体。我们将糖尿病状态分为五类：血糖正常、空腹血糖受损（IFG）、新诊断的T2DM以及病程小于5年和5年及以上的已确诊T2DM。主要终点是全因痴呆症的发病率。
在118790名参与者中（平均年龄64.26±9.95岁，48%为男性），在平均7.3±2.3年的随访期间，16.7%的人发生了痴呆症。队列入组时T2DM病程小于5年的参与者发生全因痴呆症的风险比血糖正常者高26.7%。T2DM病程为5年或更长时间的参与者风险增加46.7%，调整后的风险比（aHR）为1.466（95%置信区间[CI]，1.408 - 1.527）。具体而言，T2DM病程超过5年的个体发生阿尔茨海默病（AD）和血管性痴呆（VaD）的风险分别上升了43.4%和51.4%（aHR分别为1.434，95% CI 1.366 - 1.505；aHR 1.514，95% CI 1.365 - 1.679）。
我们的研究结果表明，T2DM病程延长与中风后人群发生全因痴呆症（包括AD和VaD）的风险增加之间存在显著关联。这些结果强调了对中风幸存者，尤其是那些患有长期T2DM的患者采取积极的痴呆症预防措施。
