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Risk of developing dementia in people with diabetes and mild cognitive impairment

  • Latha Velayudhan (a1), Michaela Poppe (a2), Nicola Archer (a2), Petroula Proitsi (a3), Richard G. Brown (a4) and Simon Lovestone (a5)...
Abstract
Background

Diabetes mellitus is associated with cognitive dysfunction, but it is not clear whether the disorder increases the risk of conversion from mild cognitive impairment to dementia.

Aims

To determine the association between diabetes mellitus and dementia conversion in people with mild cognitive impairment (Peterson's criteria) in a prospective community-based study.

Method

People over 65 years old were approached through primary care practices in south London, UK, and those with mild cognitive impairment (n = 103) were followed up for 4 years. Presence of diabetes was established from self-report and information from general practitioners.

Results

Nineteen participants progressed to dementia, with the predominant diagnosis being probable or possible Alzheimer's disease (in 84%). Only diabetes mellitus was associated with progression to dementia (hazard ratio 2.9, 95% CI 1.1–7.3) after adjustment for sociodemographic factors, APOE4, premorbid IQ and other health conditions.

Conclusions

Diabetes mellitus increases not only the risks of dementia and mild cognitive impairment but also the risk of progression from such impairment to dementia.

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Copyright
Corresponding author
Dr Latha Velayudhan, PO Box 70, Section of Old Age Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. E-mail: Latha.Velayudhan@kcl.ac.uk
Footnotes
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The study was funded by the Alzheimer's Research Trust and the UK Medical Research Council, and through the National Institute for Health Research Specialist Biomedical Research Centre for Mental Health at the South London & Maudsley National Health Service Foundation Trust.

Declaration of interest

None.

Footnotes
References
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  • EISSN: 1472-1465
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Risk of developing dementia in people with diabetes and mild cognitive impairment

  • Latha Velayudhan (a1), Michaela Poppe (a2), Nicola Archer (a2), Petroula Proitsi (a3), Richard G. Brown (a4) and Simon Lovestone (a5)...
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eLetters

MCI - risk factors

Archana Jauhari, ST6 General Adult psychiatry, Wrexham Maelor Hospital, Wrexham
12 January 2010

I read with interest the article by Velayudhan et al1 . This is a topical issue and there are other studies that have shown similar results. Study by Yaffe et al2 showed that the risk of developing mild cognitive impairment (MCI) among older adults with impaired fasting glucose and diabetes increases by almost two fold. Another study by Yaffe et al3 showed that MCI is associated with increased levels of glycosylatedhaemoglobin levels supporting the hypothesis that glucose dys-regulation predisposes to mild cognitive impairment. At the same time there are other studies (Artero et al4) that showed men with MCI were more likely tohave higher BMI, diabetes and stroke. There are certain psychosocial factors like ethnic minority status (African-Americans), low education level, higher level of chronic psychological distress, depression, socialisolation and insomnia which seems to play a part in the aetiology of MCI.This is a very important topic. Further research and awareness about thistopic will be helpful to look at preventative aspect of this important condition.

1. Velayudhan L, Poppe M et al. Risk of developing dementia in peoplewith diabetes and mild cognitive impairment. The British Journal of Psychiatry 2010; 196:36-40.

2.Yaffe K, Blackwell T et al. Diabetes, impaired fasting glucose and development of cognitive impairment in older women. Neurology 2004; 63:658-663.

3. Yaffe K, Blackwell T et al. Glycosylated hemoglobin level and development of mild cognitive impairment or dementia in older women. The Journal of nutrition, health & aging 2006;10(4): 292-295.

4.Artero S, Ancelin M-L et al. Risk profiles for mild cognitive impairment and progression to dementia are gender specific. J Neurol Neurosurg Psychiatry 2008;79;979-984.
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