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Abstract
Objective: We investigated the association between glucose tolerance status defined by a 75-g oral glucose tolerance test (OGTT) and the development of dementia.
Methods: A total of 1,017 community-dwelling dementia-free subjects aged ≥60 years who underwent the OGTT were followed up for 15 years. Outcome measure was clinically diagnosed dementia.
Results: The age- and sex-adjusted incidence of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD) were significantly higher in subjects with diabetes than in those with normal glucose tolerance. These associations remained robust even after adjustment for confounding factors for all-cause dementia and AD, but not for VaD (all-cause dementia: adjusted hazard ratio [HR] = 1.74, 95% confidence interval [CI] = 1.19 to 2.53, p = 0.004; AD: adjusted HR = 2.05, 95% CI = 1.18 to 3.57, p = 0.01; VaD: adjusted HR = 1.82, 95% CI = 0.89 to 3.71, p = 0.09). Moreover, the risks of developing all-cause dementia, AD, and VaD significantly increased with elevated 2-hour postload glucose (PG) levels even after adjustment for covariates, but no such associations were observed for fasting plasma glucose (FPG) levels: compared with those with 2-hour PG levels of <6.7 mmol/L, the multivariable-adjusted HRs of all-cause dementia and AD significantly increased in subjects with 2-hour PG levels of 7.8 to 11.0 mmol/L or over, and the risk of VaD was significantly higher in subjects with levels of ≥11.1 mmol/L.
Conclusions: 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.
GLOSSARY
- AD=
- Alzheimer disease;
- CI=
- confidence interval;
- DSM-III-R=
- Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised;
- FPG=
- fasting plasma glucose;
- HR=
- hazard ratio;
- IFG=
- impaired fasting glycemia;
- IGT=
- impaired glucose tolerance;
- NGT=
- normal glucose tolerance;
- OGTT=
- oral glucose tolerance test;
- PG=
- postload glucose;
- VaD=
- vascular dementia.
Footnotes
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Study funding: Supported in part by Grants-in-Aid for Scientific Research (nos. 20591063, 21590698, 22590892, and 22300116) from the Ministry of Education, Culture, Sports, Science and Technology of Japan, and a Health and Labour Sciences Research Grant of the Ministry of Health, Labour and Welfare of Japan (Comprehensive Research on Aging and Health: H20-Chouju-004).
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Supplemental data at www.neurology.org
- Received February 4, 2011.
- Accepted May 25, 2011.
- Copyright © 2011 by AAN Enterprises, Inc.
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