Glucose Levels and Risk of Dementia

Abstract

BACKGROUND Diabetes is a risk factor for dementia. It is unknown whether higher glucose levels increase the risk of dementia in people without diabetes. METHODS We used 35,264 clinical measurements of glucose levels and 10,208 measurements of glycated hemoglobin levels from 2067 participants without dementia to examine the relationship between glucose levels and the risk of dementia. Participants were from the Adult Changes in Thought study and included 839 men and 1228 women whose mean age at baseline was 76 years; 232 participants had diabetes, and 1835 did not. We fit Cox regression models, stratified according to diabetes status and adjusted for age, sex, study cohort, educational level, level of exercise, blood pressure, and status with respect to coronary and cerebrovascular diseases, atrial fibrillation, smoking, and treatment for hypertension. RESULTS During a median follow-up of 6.8 years, dementia developed in 524 participants (74 with diabetes and 450 without). Among participants without diabetes, higher average glucose levels within the preceding 5 years were related to an increased risk of dementia (P = 0.01); with a glucose level of 115 mg per deciliter (6.4 mmol per liter) as compared with 100 mg per deciliter (5.5 mmol per liter), the adjusted hazard ratio for dementia was 1.18 (95% confidence interval [CI], 1.04 to 1.33). Among participants with diabetes, higher average glucose levels were also related to an increased risk of dementia (P = 0.002); with a glucose level of 190 mg per deciliter (10.5 mmol per liter) as compared with 160 mg per deciliter (8.9 mmol per liter), the adjusted hazard ratio was 1.40 (95% CI, 1.12 to 1.76). CONCLUSIONS Our results suggest that higher glucose levels may be a risk factor for dementia, even among persons without diabetes. (Funded by the National Institutes of Health.)

Alzheimer’s disease and gut microbiota

“…Diabetes is usually accompanied with a moderate injury in learning and memory. A study published in New England Journal of Medicine in 2013 reported that elevated blood glucose levels would increase the risk of cognitive impairment whether they are suffering from diabetes (Crane et al, 2013). The learning and memory ability will be improved in people suffering from diabetes as the effective control of blood glucose (Vanhanen et al, 1999).…”

Connecting Type 2 diabetes to Alzheimer’s disease

“…Subsequent clinical and epidemiological studies have confirmed this association (reviewed in [4]. In fact, Type 2 diabetes patients can be more than twice as likely to develop AD [2,5]. Collectively, these studies establish that Type 2 diabetes mellitus increases the risk of developing AD.…”

Diabetes in an older woman living in a long-term care residence

“…There is growing evidence of an association between type 2 diabetes in older patients and the risk of dementia (vascular and Alzheimer type). 5 A longer duration of diabetes is associated with poorer cognitive performance. 5 The exact mechanism underlying the association between these two entities is a matter of debate, but vascular lesions and repeated hypoglycemia may be contributing factors.…”

“…5 A longer duration of diabetes is associated with poorer cognitive performance. 5 The exact mechanism underlying the association between these two entities is a matter of debate, but vascular lesions and repeated hypoglycemia may be contributing factors. Genetic factors, such as the presence of APOE4, may also be involved.…”

“…Genetic factors, such as the presence of APOE4, may also be involved. 5 The clockdrawing test is a good screening tool for cognitive problems that may affect therapy in patients with diabetes. 3 Because this patient is in a longterm care residence, concerns regarding selfmanagement of diabetes are minimized.…”