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Accelerated progression from mild cognitive impairment to dementia in people with diabetes.

Xu W, Caracciolo B, Wang HX, Winblad B, Bäckman L, Qiu C, Fratiglioni L - Diabetes (2010)

Bottom Line: Data were analyzed using standard and time-dependent Cox proportional-hazards models.Diabetes and pre-diabetes were neither cross-sectionally nor longitudinally associated with MCI.The association of diabetes with the development of MCI is less evident in old people.

View Article: PubMed Central - PubMed

Affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. weili.xu@ki.se

ABSTRACT

Objective: The effect of diabetes on mild cognitive impairment (MCI) and its conversion to dementia remains controversial. We sought to examine whether diabetes and pre-diabetes are associated with MCI and accelerate the progression from MCI to dementia.

Research design and methods: In the Kungsholmen Project, 963 cognitively intact participants and 302 subjects with MCI (120 with amnestic MCI [aMCI] and 182 with other cognitive impairment no dementia [oCIND]) age ≥ 75 years were identified at baseline. The two cohorts were followed for 9 years to detect the incident MCI and dementia following international criteria. Diabetes was ascertained based on a medical examination, hypoglycemic medication use, and random blood glucose level ≥ 11.0 mmol/l. Pre-diabetes was defined as random blood glucose level of 7.8-11.0 mmol/l in diabetes-free participants. Data were analyzed using standard and time-dependent Cox proportional-hazards models.

Results: During the follow-up period, in the cognitively intact cohort, 182 people developed MCI (42 aMCI and 140 oCIND), and 212 developed dementia. In the MCI cohort, 155 subjects progressed to dementia, the multi-adjusted hazard ratio (95% CI) of dementia was 2.87 (1.30-6.34) for diabetes, and 4.96 (2.27-10.84) for pre-diabetes. In a Kaplan-Meier survival analysis, diabetes and pre-diabetes accelerated the progression from MCI to dementia by 3.18 years. Diabetes and pre-diabetes were neither cross-sectionally nor longitudinally associated with MCI.

Conclusions: Diabetes and pre-diabetes substantially accelerate the progression from MCI to dementia, and anticipate dementia occurrence by more than 3 years in people with MCI. The association of diabetes with the development of MCI is less evident in old people.

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Related in: MedlinePlus

Flowchart of the study population in the Kungsholmen Project.
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Figure 1: Flowchart of the study population in the Kungsholmen Project.

Mentions: During the 9-year follow-up, three clinical examinations were carried out at an average interval of 3 years. Throughout the follow-up period, in the cognitively intact cohort, 357 people died and 52 dropped out. In the MCI cohort, 101 individuals died, and 13 were dropouts. Figure 1 shows the details of a flowchart of the study population from baseline to the third follow-up examination (1987–1989 to 1997–1998).


Accelerated progression from mild cognitive impairment to dementia in people with diabetes.

Xu W, Caracciolo B, Wang HX, Winblad B, Bäckman L, Qiu C, Fratiglioni L - Diabetes (2010)

Flowchart of the study population in the Kungsholmen Project.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2963552&req=5

Figure 1: Flowchart of the study population in the Kungsholmen Project.
Mentions: During the 9-year follow-up, three clinical examinations were carried out at an average interval of 3 years. Throughout the follow-up period, in the cognitively intact cohort, 357 people died and 52 dropped out. In the MCI cohort, 101 individuals died, and 13 were dropouts. Figure 1 shows the details of a flowchart of the study population from baseline to the third follow-up examination (1987–1989 to 1997–1998).

Bottom Line: Data were analyzed using standard and time-dependent Cox proportional-hazards models.Diabetes and pre-diabetes were neither cross-sectionally nor longitudinally associated with MCI.The association of diabetes with the development of MCI is less evident in old people.

View Article: PubMed Central - PubMed

Affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. weili.xu@ki.se

ABSTRACT

Objective: The effect of diabetes on mild cognitive impairment (MCI) and its conversion to dementia remains controversial. We sought to examine whether diabetes and pre-diabetes are associated with MCI and accelerate the progression from MCI to dementia.

Research design and methods: In the Kungsholmen Project, 963 cognitively intact participants and 302 subjects with MCI (120 with amnestic MCI [aMCI] and 182 with other cognitive impairment no dementia [oCIND]) age ≥ 75 years were identified at baseline. The two cohorts were followed for 9 years to detect the incident MCI and dementia following international criteria. Diabetes was ascertained based on a medical examination, hypoglycemic medication use, and random blood glucose level ≥ 11.0 mmol/l. Pre-diabetes was defined as random blood glucose level of 7.8-11.0 mmol/l in diabetes-free participants. Data were analyzed using standard and time-dependent Cox proportional-hazards models.

Results: During the follow-up period, in the cognitively intact cohort, 182 people developed MCI (42 aMCI and 140 oCIND), and 212 developed dementia. In the MCI cohort, 155 subjects progressed to dementia, the multi-adjusted hazard ratio (95% CI) of dementia was 2.87 (1.30-6.34) for diabetes, and 4.96 (2.27-10.84) for pre-diabetes. In a Kaplan-Meier survival analysis, diabetes and pre-diabetes accelerated the progression from MCI to dementia by 3.18 years. Diabetes and pre-diabetes were neither cross-sectionally nor longitudinally associated with MCI.

Conclusions: Diabetes and pre-diabetes substantially accelerate the progression from MCI to dementia, and anticipate dementia occurrence by more than 3 years in people with MCI. The association of diabetes with the development of MCI is less evident in old people.

Show MeSH
Related in: MedlinePlus