Leibson C L, Rocca W A, Hanson V A, Cha R, Kokmen E, O'Brien P C, Palumbo P J
Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.
Am J Epidemiol. 1997 Feb 15;145(4):301-8. doi: 10.1093/oxfordjournals.aje.a009106.
It is unclear whether persons with diabetes are at increased risk for dementia, including Alzheimer's disease. Existing studies are limited by small sample size, selection bias, and case-control designs. This population-based historical cohort study provides estimates of the risk of dementia and Alzheimer's disease associated with adult onset diabetes mellitus (AODM). The sample included all persons with AODM residing in Rochester, Minnesota, on January 1, 1970, plus all persons diagnosed in Rochester or who moved to Rochester with the diagnosis between January 1, 1970, and December 31, 1984. Individuals were followed through review of their complete medical records from AODM diagnosis until dementia onset, emigration, death, or January 1, 1985. Standardized morbidity ratios for dementia and Alzheimer's disease were calculated, using an expected incidence based on age- and sex-specific rates for the Rochester population. Poisson regression was used to estimate risks for persons with AODM relative to those without. Of the 1,455 cases of AODM followed for 9,981 person-years, 101 developed dementia, including 77 who met criteria for Alzheimer's disease. Persons with AODM exhibited significantly increased risk of all dementia (Poisson regression relative risk (RR) = 1.66, 95% confidence interval (CI) 1.34-2.05). Risk of Alzheimer's disease was also elevated (for men, R = 2.27, 95% CI 1.55-3.31; for women, RR = 1.37, 95% CI 0.94-2.01). These findings emphasize the importance of AODM prevention and prompt additional investigation of the relation between AODM and dementia.
糖尿病患者患痴呆症（包括阿尔茨海默病）的风险是否增加尚不清楚。现有研究受样本量小、选择偏倚和病例对照设计的限制。这项基于人群的历史性队列研究提供了与成人发病型糖尿病（AODM）相关的痴呆症和阿尔茨海默病风险的估计值。样本包括1970年1月1日居住在明尼苏达州罗切斯特市的所有AODM患者，以及1970年1月1日至1984年12月31日期间在罗切斯特市被诊断出或因该诊断移居至罗切斯特市的所有人。通过查阅他们从AODM诊断到痴呆症发病、移民、死亡或1985年1月1日的完整病历对个体进行随访。使用基于罗切斯特人群年龄和性别特异性发病率的预期发病率计算痴呆症和阿尔茨海默病的标准化发病比。采用泊松回归估计AODM患者相对于非AODM患者的风险。在随访9981人年的1455例AODM病例中，101例患痴呆症，其中77例符合阿尔茨海默病标准。AODM患者患所有痴呆症的风险显著增加（泊松回归相对风险（RR）=1.66，95%置信区间（CI）1.34 - 2.05）。阿尔茨海默病的风险也有所升高（男性，RR = 2.27，95% CI 1.55 - 3.31；女性，RR = 1.37，95% CI 0.94 - 2.01）。这些发现强调了预防AODM以及对AODM与痴呆症之间关系进行进一步深入研究的重要性。
