Key result
Diabetes is linked to ~51% higher odds of cognitive impairment or dementia.
Why the study?
To examine whether brain pathology causally mediates the relationship between diabetes and cognitive impairment.
Does diabetes mellitus increase incident mild cognitive impairment or dementia in older adults?
Cohort (n=2,872)
Yes
Does diabetes mellitus increase incident mild cognitive impairment or dementia in older adults?
Odds Ratio: 1.51 (95% CI 1.22–1.86)
p-value: p=<0.01
This study provides evidence that the increased risk of cognitive impairment in older adults with diabetes is partially mediated by cerebrovascular pathology.
Diabetes may elevate cognitive impairment risk partly via cerebrovascular pathways; supports mediation but leaves causal confirmation open for interventional studies.
leads to incident mild cognitive impairment and dementia through brain hypoperfusion and white matter disease. We performed inverse odds ratio weighted causal mediation analyses to decompose the effect of diabetes on cognitive impairment into direct and indirect effects, and we found that approximately a third of the total effect of diabetes is mediated through vascular-related brain pathology. Our findings lend support for a common aetiological hypothesis regarding incident cognitive impairment, which is that diabetes increases the risk of clinical cognitive impairment in part by impacting the vasculature of the brain.
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Andrews et al. (2020) conducted a cohort in Cognitive impairment risk in diabetes (n=2,872). Diabetes mellitus vs. Non-diabetic was evaluated on Incident mild cognitive impairment (MCI) or dementia (OR 1.51, 95% CI 1.22-1.86, p=<0.01). Diabetes mellitus increased the odds of incident mild cognitive impairment or dementia by 51% (OR 1.51), with approximately a third of this effect mediated by brain hypoperfusion and white matter disease.
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