Vol 8, No 5 (2007): Practical Diabetology
Other materials agreed with the Editors
Published online: 2007-05-24
The effect of borderline diabetes on the risk of dementia and Alzheimer’s disease
Diabetologia Praktyczna 2007;8(5):188-195.
Abstract
To verify the hypothesis that borderline diabetes may
increase the risk of dementia and Alzheimer’s disease,
a community-based cohort of 1,173 dementiaand
diabetesfree individuals aged ≥ 75 years was
longitudinally examined three times to detect patients
with dementia and Alzheimer’s disease (Diagnostic
and Statistical Manual of Mental Disorders,
Revised Third Edition criteria). Borderline diabetes
was defined as a random plasma glucose level of
7.8-11.0 mmol/l. Data were analyzed using Cox proportional
hazards models. During the 9-year follow-up,
397 subjects developed dementia, including 307 Alzheimer’s
cases. At baseline, 47 subjects were identified
with borderline diabetes. Borderline diabetes
was associated with adjusted hazard ratios (95% CIs) of 1.67 (1.04-2.67) for dementia and 1.77 (1.06-2.97)
for Alzheimer’s disease; the significant associations
were present after additional adjustment for future
development of diabetes. Stratified analysis suggested
a significant association between borderline diabetes
and Alzheimer’s disease only among noncarriers
of APOE e4 allele. There was an interaction between
borderline diabetes and severe systolic hypertension
on the risk of Alzheimer’s disease (p = 0.04). We conclude
that borderline diabetes is associated with increased
risks of dementia and Alzheimer’s disease;
the risk effect is independent of the future development
of diabetes. Borderline diabetes may interact
with severe systolic hypertension to multiply the risk
of Alzheimer’s disease.
Keywords: borderline diabetesdementiaAlzheimer’s disease