Glucose tolerance status and risk of dementia in the community

Ohara, Tomoyuki; Doi, Yasufumi; Ninomiya, Toshiharu; Hirakawa, Yoshihisa; Hata, Jun; Iwaki, Toru; Kanba, Shigenobu; Kiyohara, Yutaka

doi:10.1212/wnl.0b013e31822f0435

Cited by 377 publications

(267 citation statements)

References 31 publications

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“…Details of the methods for screening potential dementia events have been reported elsewhere 13, 14. The postal service or telephone was used to collect the health information of subjects who did not have examinations or who had moved out of town.…”

Section: Methodsmentioning

confidence: 99%

Albuminuria Increases the Risks for Both Alzheimer Disease and Vascular Dementia in Community‐Dwelling Japanese Elderly: The Hisayama Study

Takae

Hata

Ohara

et al. 2018

JAHA

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BackgroundEpidemiologic evidence has emerged to reveal an association of albuminuria and low estimated glomerular filtration rate (eGFR) with dementia, but the findings are inconsistent. In addition, there are limited studies addressing the association between albuminuria and Alzheimer disease (AD).Methods and ResultsA total of 1562 community‐dwelling Japanese subjects aged ≥60 years without dementia were followed up for 10 years. The outcomes were incidence of all‐cause dementia and its subtypes, namely, AD and vascular dementia (VaD). The hazard ratios for the outcomes were estimated according to urine albumin–creatinine ratio (UACR) and eGFR levels using a Cox proportional hazards model. During the follow‐up, 358 subjects developed all‐cause dementia (238 AD and 93 VaD). Higher UACR level was significantly associated with greater multivariable‐adjusted risks of all‐cause dementia (hazard ratios [95% confidence intervals]: 1.00 [reference], 1.12 [0.78–1.60], 1.65 [1.18–2.30], and 1.56 [1.11–2.19] for UACR of ≤6.9, 7.0–12.7, 12.8–29.9, and ≥30.0 mg/g, respectively), AD (1.00 [reference], 1.20 [0.77–1.86], 1.75 [1.16–2.64], and 1.58 [1.03–2.41], respectively), and VaD (1.00 [reference], 1.03 [0.46–2.29], 1.94 [0.96–3.95], and 2.19 [1.09–4.38], respectively). On the other hand, lower eGFR level was marginally associated with greater risk of VaD, but not AD. Subjects with UACR ≥12.8 mg/g and eGFR of <60 mL/min per 1.73 m2 had 3.3‐fold greater risk of VaD than those with UACR <12.8 mg/g and eGFR of ≥60 mL/min per 1.73 m2.ConclusionsAlbuminuria is a significant risk factor for the development of both AD and VaD in community‐dwelling Japanese elderly. Moreover, albuminuria and low eGFR are mutually associated with a greater risk of VaD.

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Section: Methodsmentioning

confidence: 99%

Albuminuria Increases the Risks for Both Alzheimer Disease and Vascular Dementia in Community‐Dwelling Japanese Elderly: The Hisayama Study

Takae

Hata

Ohara

et al. 2018

JAHA

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“…The Hisayama Study is a populationbased prospective study of cerebro-and cardiovascular diseases and dementia in a general Japanese population. Using the data from the Hisayama Study, we previously observed that diabetes and elevated 2-h postload glucose (PG) concentrations were significantly associated with the development of Alzheimer disease (8) and neuritic plaque formation (9). The current study was conducted to investigate the association between diabetes-related parameters and brain and hippocampal atrophy, using MRI scans in elderly residents of Hisayama, Japan.…”

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confidence: 99%

Association Between Diabetes and Hippocampal Atrophy in Elderly Japanese: The Hisayama Study

et al. 2016

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OBJECTIVETo investigate the association between diabetes and brain or hippocampal atrophy in an elderly population. RESEARCH DESIGN AND METHODSA total of 1,238 community-dwelling Japanese subjects aged ‡65 years underwent brain MRI scans and a comprehensive health examination in 2012. Total brain volume (TBV), intracranial volume (ICV), and hippocampal volume (HV) were measured using MRI scans for each subject. We examined the associations between diabetes-related parameters and the ratios of TBV to ICV (an indicator of global brain atrophy), HV to ICV (an indicator of hippocampal atrophy), and HV to TBV (an indicator of hippocampal atrophy beyond global brain atrophy) after adjustment for other potential confounders. RESULTSThe multivariable-adjusted mean values of the TBV-to-ICV, HV-to-ICV, and HV-to-TBV ratios were significantly lower in the subjects with diabetes compared with those without diabetes (77.6% vs. 78.2% for the TBV-to-ICV ratio, 0.513% vs. 0.529% for the HV-to-ICV ratio, and 0.660% vs. 0.676% for the HV-to-TBV ratio; all P < 0.01). These three ratios decreased significantly with elevated 2-h postload glucose (PG) levels (all P for trend <0.05) but not fasting plasma glucose levels. Longer duration of diabetes was significantly associated with lower TBV-to-ICV, HV-to-ICV, and HV-to-TBV ratios. The subjects with diabetes diagnosed in midlife had significantly lower HV-to-ICV and HV-to-TBV ratios than those without and those diagnosed in late life. CONCLUSIONSOur data suggest that a longer duration of diabetes and elevated 2-h PG levels, a marker of postprandial hyperglycemia, are risk factors for brain atrophy, particularly hippocampal atrophy.

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“…The observations are a "one-time-point" observation, and not a follow-up study, and therefore, one cannot conclude from these data that DM leads to an increase in the risk of developing AD. However, this conclusion was reached by Ohara et al (24) in a 15-year follow-up study.…”

Section: Discussionmentioning

confidence: 89%

“…The magnitude of this WHO epidemiological category is such that it accounts for 60% of all deaths worldwide, surpassing by a high margin the group of infectious diseases, including HIV/AIDS, TB and malaria. DM is another risk for AD (24). The relationship between DM and AD has been found to be particularly strong in patients with the ε4 allele of APOE (APOE4) (25), and DM has been proposed to be associated with sporadic and familial LOAD (26)(27)(28).…”

mentioning

confidence: 99%

“…Insulin and glucose dysregulation can also alter amyloid metabolism by changing the insulin/insulin receptor interaction (52) and by the formation of AGEs (53). DM is another risk for AD, although the molecular pathways connecting DM and AD are unknown (24). The fourth and fifth stages (known as The Honolulu Asia Aging Study) of the so-called "Honolulu Heart Program" were designed to investigate risk factors associated with neurodegenerative disorders and aging.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Diabetes mellitus en pacientes con enfermedad de Alzheimer: descripción clínica y correlación con el genotipo APOE en una muestra de población del departamento de Antioquia, Colombia

et al. 2012

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Glucose tolerance status and risk of dementia in the community

Abstract: Our findings suggest that diabetes is a significant risk factor for all-cause dementia, AD, and probably VaD. Moreover, 2-hour PG levels, but not FPG levels, are closely associated with increased risk of all-cause dementia, AD, and VaD.

Cited by 377 publications

References 31 publications

Albuminuria Increases the Risks for Both Alzheimer Disease and Vascular Dementia in Community‐Dwelling Japanese Elderly: The Hisayama Study

Albuminuria Increases the Risks for Both Alzheimer Disease and Vascular Dementia in Community‐Dwelling Japanese Elderly: The Hisayama Study

Association Between Diabetes and Hippocampal Atrophy in Elderly Japanese: The Hisayama Study

Diabetes mellitus en pacientes con enfermedad de Alzheimer: descripción clínica y correlación con el genotipo APOE en una muestra de población del departamento de Antioquia, Colombia

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