Gonzalez Tovar Maria Camila, Salinas Daniel, Baker Kelsey
Neurology, University of Texas Rio Grande Valley School of Medicine, Edinburg, USA.
Neurology, University of Texas Rio Grande Valley School of Medicine, Harlingen, USA.
Cureus. 2025 Jun 15;17(6):e86086. doi: 10.7759/cureus.86086. eCollection 2025 Jun.
Alzheimer's disease (AD) is becoming more prevalent worldwide, leading to a growing demand to understand the impact of risk factors on disease progression. Notably, type 2 diabetes mellitus (DM) has emerged as a significant risk factor for the development of AD, given the pathophysiological role of insulin resistance in cognitive impairment. In particular, the impact of type 2 DM on AD development and severity may be heightened in Hispanic populations due to the high prevalence of both conditions in this community. Here, we sought to understand the role of type 2 DM in AD severity in a Hispanic population from the Rio Grande Valley (RGV), a community wherein 91% of the population identifies as Hispanic.
We conducted a pilot retrospective chart review from January 2018 to March 2024 at UTHealth RGV for patients with AD who self-identified as Hispanic, Mexican, or Latino. Medical charts were evaluated for a diagnosis of type 2 DM, and demographics were recorded. We categorized the included charts into two groups: AD with DM and AD without DM. For all charts, the Global Deterioration Scale (GDS) score was manually determined from the electronic medical record. T-tests were used to evaluate differences between the two groups.
Forty patients met the inclusion criteria for our study. Eleven medical charts were excluded (72.5% analysis rate) due to insufficient documentation for GDS scoring. No significant differences were found in baseline demographics between the AD with DM and AD without DM groups. GDS scores were not statistically different between groups (p = 0.152), although a medium effect size was observed (d = 0.52, 95% CI (-0.18, 1.23)), with higher GDS scores in the AD with DM group.
Our findings suggest a trend toward more severe AD in Hispanic patients with type 2 DM. Based on these results, we recommend the development of standardized assessment tools for AD, particularly for use in small community clinics, to improve the evaluation of disease progression. Improved clinical documentation and assessment may help identify risk factors that allow for earlier diagnosis or preventive interventions.
阿尔茨海默病（AD）在全球范围内日益普遍，这使得人们越来越需要了解风险因素对疾病进展的影响。值得注意的是，鉴于胰岛素抵抗在认知障碍中的病理生理作用，2型糖尿病（DM）已成为AD发生的一个重要风险因素。特别是，由于这两种疾病在西班牙裔人群中患病率较高，2型DM对AD发生和严重程度的影响在西班牙裔人群中可能更为突出。在此，我们试图了解2型DM在来自里奥格兰德河谷（RGV）的西班牙裔人群AD严重程度中的作用，该社区91%的人口为西班牙裔。
我们于2018年1月至2024年3月在德克萨斯大学健康科学中心里奥格兰德河谷分校对自我认定为西班牙裔、墨西哥裔或拉丁裔的AD患者进行了一项回顾性病历审查试点研究。评估病历以确定2型DM诊断，并记录人口统计学数据。我们将纳入的病历分为两组：合并DM的AD组和未合并DM的AD组。对于所有病历，从电子病历中手动确定全球衰退量表（GDS）评分。采用t检验评估两组之间的差异。
40名患者符合我们研究的纳入标准。由于GDS评分的记录不足，11份病历被排除（分析率72.5%）。合并DM的AD组和未合并DM的AD组在基线人口统计学方面未发现显著差异。两组之间的GDS评分无统计学差异（p = 0.152），尽管观察到中等效应量（d = 0.52，95%置信区间（-0.18，1.23）），合并DM的AD组GDS评分更高。
我们的研究结果表明，2型DM的西班牙裔患者中AD有更严重的趋势。基于这些结果，我们建议开发用于AD的标准化评估工具，特别是用于小型社区诊所，以改善疾病进展的评估。改进临床记录和评估可能有助于识别可实现早期诊断或预防性干预的风险因素。
