November 1, 2006Archives of Neurology
Diabetes Mellitus and Risk of Developing Alzheimer Disease
Authors
Discussion
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Implication
Prospective cohort study finds no overall Alzheimer disease risk from diabetes in older adults, highlighting heightened susceptibility specifically in those without other major risk factors.
Key Points
- To evaluate and compare the risk of developing incident Alzheimer disease among individuals with and without diabetes mellitus.
- Prospective community-based cohort study examining 2,210 dementia-free participants (1,325 women; mean age, 70 years) from the Framingham Study Original cohort at their 16th biennial examination.
- Baseline diabetes mellitus was classified by casual plasma glucose ≥200 mg/dL (≥11.1 mmol/L) or use of insulin or oral hypoglycemic agents, with incident Alzheimer disease tracked over a mean follow-up of 12.7 years (range, 1–20 years).
- Multivariable models adjusted for age, sex, and cardiovascular risk factors, with subgroup analyses stratified by apolipoprotein E genotype and plasma homocysteine levels.
- Overall incident Alzheimer disease occurred in 17 of 202 participants with diabetes (8.4%) versus 220 of 2,008 participants without diabetes (11.0%), demonstrating a relative risk of 1.15 (95% CI, 0.65–2.05).
- Among individuals lacking both the apolipoprotein E epsilon4 allele and elevated homocysteine, 44 of 684 (6.4%) developed Alzheimer disease, with diabetes conferring a relative risk of 2.98 (95% CI, 1.06–8.39; P = .03).
- In the subgroup without other major risk factors, the risk was most pronounced among individuals aged 75 years or older, showing a relative risk of 4.77 (95% CI, 1.28–17.72; P = .02).
Cite This Study
Akomolafe et al. (2006) studied this question.