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Clinical Summary

Mild cognitive impairment and progression to dementia: what are the risk factors?

Takeaway

  • Diabetes, prediabetes and metabolic syndrome (MetS) were all associated with increased risks of progression of mild cognitive impairment (MCI) to dementia.

Why this matters

  • Meta-analysis identified a number of potential risk factors in patients with diabetes and MetS that could be targeted to reduce the risks of progression of MCI to dementia.

Study design

  • 12 studies involving 6865 participants met eligibility criteria after a search on Medline, Embase, PsycINFO, PsycArticles, and Web of Science.
  • Funding: None disclosed.

Key results

  • The overall unadjusted pooled OR for the progression of MCI to dementia in:
    • people with diabetes, prediabetes or MetS was 1.67 (95% CI, 1.27-2.19),
    • people with diabetes was 1.53 (95% CI, 1.20-1.97) and
    • people with MetS was 2.95 (95% CI, 1.23-7.05).
  • Longer duration of diabetes (aHRs increased from 1.04 after 2 years to 1.42 after > 5 years), and diabetic retinopathy were associated with increased risk of progression.
  • Statin use lowered the risk of progression (aHR, 0.86;95% CI, 0.84-0.90).
  • Oral hypoglycaemic agents were associated with reduced risk of developing dementia (HR, 0.93; 95% CI, 0.90-0.96).
  • Incident rate of progression to dementia with ≥3 cardiovascular risks factors was 67.6 (95% CI, 35.17-129.93).

Limitations

  • Lack of studies looking at risk factors for progression in patients with type 2 diabetes mellitus.
  • Only 4 studies provided details of the type of dementia diagnosed.

References


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