Risk factors for dementia with type 2 diabetes mellitus among elderly people in China
Risk factors for dementia with type 2 diabetes mellitus among elderly people in China
复制标题
中国老年人2型糖尿病合并痴呆的危险因素
DOI：
10.1093/ageing/afs188
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发表时间：
2013-05-01
期刊：
影响因子：
6.7
通讯作者：
Lin, Gao
中科院分区：
文献类型：
--
作者：
Fei, Ma;Ping, Zhang Yan;Lin, Gao
目的：了解中国老年人群中糖尿病与痴呆及其亚型阿尔茨海默病(AD)和血管性痴呆(VD)的患病率及其危险因素。方法：在8213名65岁及以上中国人人群中，通过访谈法和直接血糖试验确定1,109名2型糖尿病患者。所有糖尿病受试者最初都接受了痴呆症及其亚型的“DSM-IV标准”筛查。我们比较了糖尿病患者和普通人群中痴呆的患病率，并分析了糖尿病与痴呆(包括AD和VD)的关系。用Logistic回归分析T2 DM对痴呆及其亚型的OR。结果：经过综合的老年和认知评估，132例糖尿病患者被诊断为全因痴呆。2型糖尿病痴呆患病率为1.61%。痴呆患者中，AD患者37例，VD患者30例。AD合并T2 DM的患病率为4.51%，VD合并T2 DM的患病率为3.65%。单因素分析显示，在所有糖尿病患者中，痴呆患者(包括AD和VD患者)与认知完整患者相比，年龄更大，女性更多，当前吸烟比例更高，糖尿病病程更长，糖尿病药物使用更频繁，APOE epsilon 4状态的影响更强。在多因素Logistic回归分析中，年龄、APOE epsilon 4等位基因、糖尿病起病时间、口服降糖药、HMG-CoA还原酶(他汀类药物)与T2 DM合并痴呆的风险增加显著相关(均P<0.05)。结论：本研究表明T2 DM与中国人群中的老年痴呆及其亚型有关。
Objective: to investigate the prevalence and risk factors of diabetes to dementia and its subtypes such as Alzheimer disease (AD) and vascular dementia (VD) among the Chinese elderly population.Methods: among 8,213 Chinese people aged 65 years and older, 1,109 subjects with type 2 diabetes millitus (T2DM) were ascertained by interview and direct glucose testing. All diabetic subjects were initially screened with the "DSM-IV criteria" for dementia and its subtypes. We compared the prevalence of dementia in diabetic patients with that in ordinary subjects, and analyzed the association of the status of diabetes with dementia including AD and VD. Logistic regression was used to assess OR of dementia and its subtypes with T2DM.Results: after a comprehensive geriatric and cognitive assessment, 132 diabetic subjects were diagnosed with all-cause dementia. The prevalence rate for dementia with T2DM was 1.61%. Of demented subjects, 37 subjects had AD, 30 subjects had VD. The prevalence rates for AD with T2DM and VD with T2DM were 4.51% and 3.65%, respectively. In the univariate analyses, among all diabetic subjects, compared with cognitive intactly subjects, the demented subjects, including AD and VD subjects, were older, more female had higher percentage of current smoking, had a greater duration of diabetes, took more frequent use of diabetes medications, and stronger effect of APOE epsilon 4 status. In multivariate logistic regression analyses, variables including age, APOE epsilon 4 allele, duration from onset of diabetes, using oral hypoglycemic agents, HMG-CoA reductase (statins) were significantly associated with increased risk for dementia with T2DM (all P < 0.05).Conclusions: the present study shows that T2DM is associated with dementia and its subtypes amongst elderly people in the Chinese population.