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Diabetes mellitus and risk of dementia: A meta-analysis of prospective observational studies.

Gudala K, Bansal D, Schifano F, Bhansali A - J Diabetes Investig (2013)

Bottom Line: Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using the random-effects model.Higher and medium quality studies did not show any significant difference for pooled RR for ATD, AD or VaD.Sensitivity analyses showed robustness of pooled RR among ATD, AD and VaD, showing no single study had a major impact on pooled RR.

View Article: PubMed Central - PubMed

Affiliation: Clinical Research Unit Department of Pharmacy Practice National Institute of Pharmaceutical Education and Research Mohali India.

ABSTRACT

Aims/introduction: The aim of the present study was to investigate the association between diabetes and the risk of all type dementia (ATD), Alzheimer's disease (AD) and vascular dementia (VaD).

Materials and methods: Prospective observational studies describing the incidence of ATD, AD and VaD in patients with diabetes mellitus were extracted from PubMed, EMBASE and other databases up to January 2012. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using the random-effects model. Subgroup analyses and sensitivity analysis were also carried out.

Results: A total of 28 studies contributed to the analysis. Pooled RR of developing ATD (n = 20) was 1.73 (1.65-1.82, I (2) = 71.2%), AD (n = 20) was 1.56 (1.41-1.73, I (2) = 9.8%) and VaD (n = 13) was 2.27 (1.94-2.66, I (2) = 0%) in patients with diabetes mellitus. Higher and medium quality studies did not show any significant difference for pooled RR for ATD, AD or VaD. Sensitivity analyses showed robustness of pooled RR among ATD, AD and VaD, showing no single study had a major impact on pooled RR.

Conclusions: The results showed a 73% increased risk of ATD, 56% increase of AD and 127% increase of VaD in diabetes patients.

No MeSH data available.


Related in: MedlinePlus

Diabetes and risk of all type dementia. CI, confidence interval.
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jdi12087-fig-0002: Diabetes and risk of all type dementia. CI, confidence interval.

Mentions: As significant heterogeneity was found between studies (Pheterogeneity < 0.01, I2 = 71.2%), a random‐effects model was chosen over a fixed‐effect model (Table 2). Patients with diabetes were found to be at a significantly higher risk of ATD compared with the non‐diabetic population (pooled RR 1.73 (95% CI 1.65–1.82, P ≤ 0.001). The multivariable‐adjusted RR of dementia for each study and all studies combined are shown in Figure 2. Visual examination of the funnel plot showed minimal asymmetry, further confirmed by Egger's test (P = 0.83), indicating little or no publication bias in our analysis. Sensitivity analyses showed robustness of pooled RR, as RR values lay within the range of 1.57–1.63, thus clearly showing no major impact of any single study on pooled RR. Table 3 presents the results of subgroup analyses stratified by quality rating and adjustment for risk factors. There was no statistically significant difference observed among studies reporting the incidence of ATD subgrouped on the basis of follow up (Pinteraction = 0.13), adjustment for BMI (Pinteraction = 0.49), cardiovascular disease (Pinteraction = 0.84) and APOE ε4 allele (Pinteraction = 0.16). When studies were analyzed according to study quality assessed using NOS, high‐quality studies reported a stronger association (pooled RR 1.61, 95% CI 1.43–1.81, P ≤ 0.001) as compared with medium quality studies (pooled RR 1.54, 95% CI 1.10–2.15, P ≤ 0.001). We did not find a significant difference (Pinteraction = 0.80) in the two pooled RR, as the studies were grouped according to the study quality.


Diabetes mellitus and risk of dementia: A meta-analysis of prospective observational studies.

Gudala K, Bansal D, Schifano F, Bhansali A - J Diabetes Investig (2013)

Diabetes and risk of all type dementia. CI, confidence interval.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4020261&req=5

jdi12087-fig-0002: Diabetes and risk of all type dementia. CI, confidence interval.
Mentions: As significant heterogeneity was found between studies (Pheterogeneity < 0.01, I2 = 71.2%), a random‐effects model was chosen over a fixed‐effect model (Table 2). Patients with diabetes were found to be at a significantly higher risk of ATD compared with the non‐diabetic population (pooled RR 1.73 (95% CI 1.65–1.82, P ≤ 0.001). The multivariable‐adjusted RR of dementia for each study and all studies combined are shown in Figure 2. Visual examination of the funnel plot showed minimal asymmetry, further confirmed by Egger's test (P = 0.83), indicating little or no publication bias in our analysis. Sensitivity analyses showed robustness of pooled RR, as RR values lay within the range of 1.57–1.63, thus clearly showing no major impact of any single study on pooled RR. Table 3 presents the results of subgroup analyses stratified by quality rating and adjustment for risk factors. There was no statistically significant difference observed among studies reporting the incidence of ATD subgrouped on the basis of follow up (Pinteraction = 0.13), adjustment for BMI (Pinteraction = 0.49), cardiovascular disease (Pinteraction = 0.84) and APOE ε4 allele (Pinteraction = 0.16). When studies were analyzed according to study quality assessed using NOS, high‐quality studies reported a stronger association (pooled RR 1.61, 95% CI 1.43–1.81, P ≤ 0.001) as compared with medium quality studies (pooled RR 1.54, 95% CI 1.10–2.15, P ≤ 0.001). We did not find a significant difference (Pinteraction = 0.80) in the two pooled RR, as the studies were grouped according to the study quality.

Bottom Line: Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using the random-effects model.Higher and medium quality studies did not show any significant difference for pooled RR for ATD, AD or VaD.Sensitivity analyses showed robustness of pooled RR among ATD, AD and VaD, showing no single study had a major impact on pooled RR.

View Article: PubMed Central - PubMed

Affiliation: Clinical Research Unit Department of Pharmacy Practice National Institute of Pharmaceutical Education and Research Mohali India.

ABSTRACT

Aims/introduction: The aim of the present study was to investigate the association between diabetes and the risk of all type dementia (ATD), Alzheimer's disease (AD) and vascular dementia (VaD).

Materials and methods: Prospective observational studies describing the incidence of ATD, AD and VaD in patients with diabetes mellitus were extracted from PubMed, EMBASE and other databases up to January 2012. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using the random-effects model. Subgroup analyses and sensitivity analysis were also carried out.

Results: A total of 28 studies contributed to the analysis. Pooled RR of developing ATD (n = 20) was 1.73 (1.65-1.82, I (2) = 71.2%), AD (n = 20) was 1.56 (1.41-1.73, I (2) = 9.8%) and VaD (n = 13) was 2.27 (1.94-2.66, I (2) = 0%) in patients with diabetes mellitus. Higher and medium quality studies did not show any significant difference for pooled RR for ATD, AD or VaD. Sensitivity analyses showed robustness of pooled RR among ATD, AD and VaD, showing no single study had a major impact on pooled RR.

Conclusions: The results showed a 73% increased risk of ATD, 56% increase of AD and 127% increase of VaD in diabetes patients.

No MeSH data available.


Related in: MedlinePlus