Association between hypoglycemia and dementia in a biracial cohort of older adults with diabetes mellitus.
Association between hypoglycemia and dementia in a biracial cohort of older adults with diabetes mellitus.
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DOI：
10.1001/jamainternmed.2013.6176
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发表时间：
2013-07-22
影响因子：
39
通讯作者：
Schwartz, Ann V.
中科院分区：
文献类型：
--
作者：
Yaffe, Kristine;Falvey, Cherie M.;Hamilton, Nathan;Harris, Tamara B.;Simonsick, Eleanor M.;Strotmeyer, Elsa S.;Shorr, Ronald I.;Metti, Andrea;Schwartz, Ann V.
低血糖常见于糖尿病 (DM) 患者，可能会对认知能力产生负面影响。认知障碍反过来会影响糖尿病管理并导致低血糖。前瞻性评估双种族老年糖尿病患者队列中低血糖与痴呆之间的关联。基于人群的前瞻性研究。我们研究了 783 名患有 DM 的老年人（平均年龄 74.0 岁；47.0% 为黑人种族/族裔；47.6% 为女性），他们参加了 1997 年开始的基于人群的前瞻性健康、老龄化和身体成分研究，基线改良简易精神状态检查分数为 80 或更高。痴呆症诊断是在随访期间根据医院记录确定的，该记录表明与痴呆症相关的入院或使用处方痴呆症药物。低血糖事件是在随访期间根据医院记录确定的。在 12 年的随访期间，61 名参与者（7.8%）报告了低血糖事件，148 名参与者（18.9%）患上了痴呆症。与没有发生低血糖事件的人相比，经历过低血糖事件的人患痴呆症的风险增加了 2 倍（34.4% vs 17.6%，P < .001；多变量调整风险比，2.1；95% CI，1.0-4.4）。同样，与未患痴呆的参与者相比，患有痴呆的老年糖尿病患者发生后续低血糖事件的风险更大（14.2% vs 6.3%，P < .001；多变量调整风险比，3.1；95% CI，1.5-6.6）。对中风、高血压、心肌梗死和认知变化评分的进一步调整产生了类似的结果。在患有糖尿病的老年人中，低血糖和痴呆之间似乎存在双向关联。
Hypoglycemia commonly occurs in patients with diabetes mellitus (DM) and may negatively influence cognitive performance. Cognitive impairment in turn can compromise DM management and lead to hypoglycemia. To prospectively evaluate the association between hypoglycemia and dementia in a biracial cohort of older adults with DM. Prospective population-based study. We studied 783 older adults with DM (mean age, 74.0 years; 47.0% of black race/ethnicity; and 47.6% female) who were participating in the prospective population-based Health, Aging, and Body Composition Study beginning in 1997 and who had baseline Modified Mini-Mental State Examination scores of 80 or higher. Dementia diagnosis was determined during the follow-up period from hospital records indicating an admission associated with dementia or the use of prescribed dementia medications. Hypoglycemic events were determined during the follow-up period by hospital records. During the 12-year follow-up period, 61 participants (7.8%) had a reported hypoglycemic event, and 148 (18.9%) developed dementia. Those who experienced a hypoglycemic event had a 2-fold increased risk for developing dementia compared with those who did not have a hypoglycemic event (34.4% vs 17.6%, P < .001; multivariate-adjusted hazard ratio, 2.1; 95% CI, 1.0–4.4). Similarly, older adults with DM who developed dementia had a greater risk for having a subsequent hypoglycemic event compared with participants who did not develop dementia (14.2% vs 6.3%, P < .001; multivariate-adjusted hazard ratio, 3.1; 95% CI, 1.5–6.6). Further adjustment for stroke, hypertension, myocardial infarction, and cognitive change scores produced similar results. Among older adults with DM, there seems to be a bidirectional association between hypoglycemia and dementia.
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影响因子：
158.5
作者：
Duckworth, William;Abraira, Carlos;Huang, Grant D.
通讯作者：
Huang, Grant D.
影响因子：
158.5
作者：
Gerstein, Hertzel C.;Miller, Michael E.;Friedewald, William T.
通讯作者：
Friedewald, William T.
DOI：
10.1152/ajpendo.91041.2008
发表时间：
2009-07-01
影响因子：
5.1
作者：
Bree, Adam J.;Puente, Erwin C.;Fisher, Simon J.
通讯作者：
Fisher, Simon J.
影响因子：
3
作者：
Umegaki, Hiroyuki
通讯作者：
Umegaki, Hiroyuki
影响因子：
16.2
作者：
Punthakee Z;Miller ME;Launer LJ;Williamson JD;Lazar RM;Cukierman-Yaffee T;Seaquist ER;Ismail-Beigi F;Sullivan MD;Lovato LC;Bergenstal RM;Gerstein HC;ACCORD Group of Investigators;ACCORD-MIND Investigators
通讯作者：
ACCORD-MIND Investigators