- Type 2 diabetes (T2D) is associated with a higher risk for vascular dementia (VD).
- Poor glycaemic control (HbA1c >53 mmol/L) in T2D increases risk for VD and non-vascular dementia (NVD).
- Influence of risk factors for dementia in T2D varies by dementia subtypes.
- Identification of modifiable lifestyle risk factors in high-risk individuals along with preventative approaches could alleviate dementia risk in patients with T2D.
Why this matters
- T2D is associated with increased dementia risk, but its relation with dementia subtypes has not been studied extensively.
- An observational study (median follow-up, 6.7 years) analysed data of 378,299 patients with T2D (mean age, 64.13 years) and 1,886,022 matched control participants from the Swedish National Diabetes Registry.
- Outcomes: risk for Alzheimer’s disease (AD), VD and NVD.
- Funding: Swedish State and others.
- 10,143 and 46,479 participants developed dementia in T2D and control cohorts, respectively.
- Patients with T2D had the highest risk for VD (HR, 1.35), followed by NVD (HR, 1.08), and a lower risk for AD (HR, 0.92).
- Compared with patients with T2D having optimal HbA1C (
- Compared with patients with T2D having HbA1C
- Age, diabetes duration, existing cardiovascular diseases (CVDs), body mass index and blood pressure were key factors mediating dementia risk in T2D.
- CVD-related factors increased the risk for VD by 40%, NVD by 20% and AD by 10% in patients with T2D.
- No direct cause and effect could be established, owing to the observational nature of the study.
- Change in lifestyle-related factors was not followed up.