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Type 2 Diabetes as a Risk Factor for Dementia in Women Compared With Men: A Pooled Analysis of 2.3 Million People Comprising More Than 100,000 Cases of Dementia

Journal article
Authors Saion Chatterjee
Sanne Peters
Mark Woodward
Silvia Arango
David Batty
Nigel Beckett
Alexa Beiser
Amy Borenstein
Paul Crane
Mary Haan
Linda Hassing
Kathleen Hayden
Kiyohara Yutaka
Eric Larson
Chung-Yi Li
Toshiharu Ninomiya
Tomoyuki Ohara
Ruth Peters
Tom Russ
Sudha Seshadri
Bjorn Strand
Rod Walker
Weili Xu
Rachel Huxley
Published in Diabetes Care
Volume 39
Issue 2
Pages 300-307
ISSN 0149-5992
Publication year 2016
Published at Department of Psychology
Pages 300-307
Language en
Links dx.doi.org/10.2337/dc15-1588
Keywords Dementia
Subject categories Neuroscience, Diabetology

Abstract

OBJECTIVE Type 2 diabetes confers a greater excess risk of cardiovascular disease in women than in men. Diabetes is also a risk factor for dementia, but whether the association is similar in women and men remains unknown. We performed a meta-analysis of unpublished data to estimate the sex-specific relationship between women and men with diabetes with incident dementia. RESEARCH DESIGN AND METHODS A systematic search identified studies published prior to November 2014 that had reported on the prospective association between diabetes and dementia. Study authors contributed unpublished sex-specific relative risks (RRs) and 95% CIs on the association between diabetes and all dementia and its subtypes. Sex-specific RRs and the women-to-men ratio of RRs (RRRs) were pooled using random-effects meta-analyses. RESULTS Study-level data from 14 studies, 2,310,330 individuals, and 102,174 dementia case patients were included. In multiple-adjusted analyses, diabetes was associated with a 60% increased risk of any dementia in both sexes (women: pooled RR 1.62 [95% CI 1.45–1.80]; men: pooled RR 1.58 [95% CI 1.38–1.81]). The diabetes-associated RRs for vascular dementia were 2.34 (95% CI 1.86–2.94) in women and 1.73 (95% CI 1.61–1.85) in men, and for nonvascular dementia the RRs were 1.53 (95% CI 1.35–1.73) in women and 1.49 (95% CI 1.31–1.69) in men. Overall, women with diabetes had a 19% greater risk for the development of vascular dementia than men (multiple-adjusted RRR 1.19 [95% CI 1.08–1.30]; P < 0.001). CONCLUSIONS Individuals with type 2 diabetes are at ∼60% greater risk for the development of dementia compared with those without diabetes. For vascular dementia, but not for nonvascular dementia, the additional risk is greater in women.

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