TY - JOUR
T1 - Risk of dementia among persons with diabetes mellitus
T2 - A population- based cohort study
AU - Leibson, Cynthia L.
AU - Rocca, W. A.
AU - Hanson, V. A.
AU - Cha, R.
AU - Kokmen, E.
AU - O'Brien, P. C.
AU - Palumbo, P. J.
N1 - Funding Information:
This research was supported by National Institute on Aging grants AG08729 and AG08031.
Funding Information:
The opportunity for population-based historical cohort studies in Rochester, Minnesota, is the result of an unusual set of circumstances. Rochester is relatively isolated from other population centers, and it is the home of the Mayo Clinic, one of the largest tertiary care medical centers in the world. Therefore, since the turn of the twentieth century, Rochester residents have received essentially all of their medical care from a small number of providers. Also, all information from every contact for each patient, including hospital in-patient, hospital outpatient, office visit, emergency room, nursing home, death certificate, and autopsy, is contained within a unit medical record. The diagnoses assigned and surgical procedures performed at each visit are coded and entered into centrally located and continuously updated computer files. With funding from the National Institutes of Health, this indexing system has been expanded to include non-Mayo providers of care to local residents. Under the auspices of the Rochester Epidemiology Project (22), these resources have afforded investigation of the natural history of disease for numerous conditions, including diabetes and dementia. Rochester Epidemiology Project investigations of disease incidence are typically initiated with a computerized listing of all Rochester residents assigned any diagnostic rubric associated with the condition of interest during the study period. The complete community-based medical records for these potential cases are then retrieved and reviewed by trained nurse abstractors who, under the direction of clinical specialists, apply standardized case criteria and assign date of diagnosis.
PY - 1997
Y1 - 1997
N2 - It is unclear whether persons with diabetes are at increased risk for dementia, including Alzheimer's disease. Existing studies are limited by small sample size, selection bias, and case-control designs. This population- based historical cohort study provides estimates of the risk of dementia and Alzheimer's disease associated with adult onset diabetes mellitus (AODM). The sample included all persons with AODM residing in Rochester, Minnesota, on January 1, 1970, plus all persons diagnosed in Rochester or who moved to Rochester with the diagnosis between January 1, 1970, and December 31, 1984. Individuals were followed through review of their complete medical records from AODM diagnosis until dementia onset, emigration, death, or January 1, 1985. Standardized morbidity ratios for dementia and Alzheimer's disease were calculated, using an expected incidence based on age- and sex-specific rates for the Rochester population. Poisson regression was used to estimate risks for persons with AODM relative to those without. Of the 1,455 cases of AODM followed for 9,981 person-years, 101 developed dementia, including 77 who met criteria for Alzheimer's disease. Persons with AODM exhibited significantly increased risk of all dementia (Poisson regression relative risk (RR) = 1.66, 95% confidence interval (CI) 1.34-2.05). Risk of Alzheimer's disease was also elevated (for men, RR = 2.27, 95% CI 1.55-3.31; for women, RR = 1.37, 95% CI 0.94-2.01). These findings emphasize the importance of AODM prevention and prompt additional investigation of the relation between AODM and dementia.
AB - It is unclear whether persons with diabetes are at increased risk for dementia, including Alzheimer's disease. Existing studies are limited by small sample size, selection bias, and case-control designs. This population- based historical cohort study provides estimates of the risk of dementia and Alzheimer's disease associated with adult onset diabetes mellitus (AODM). The sample included all persons with AODM residing in Rochester, Minnesota, on January 1, 1970, plus all persons diagnosed in Rochester or who moved to Rochester with the diagnosis between January 1, 1970, and December 31, 1984. Individuals were followed through review of their complete medical records from AODM diagnosis until dementia onset, emigration, death, or January 1, 1985. Standardized morbidity ratios for dementia and Alzheimer's disease were calculated, using an expected incidence based on age- and sex-specific rates for the Rochester population. Poisson regression was used to estimate risks for persons with AODM relative to those without. Of the 1,455 cases of AODM followed for 9,981 person-years, 101 developed dementia, including 77 who met criteria for Alzheimer's disease. Persons with AODM exhibited significantly increased risk of all dementia (Poisson regression relative risk (RR) = 1.66, 95% confidence interval (CI) 1.34-2.05). Risk of Alzheimer's disease was also elevated (for men, RR = 2.27, 95% CI 1.55-3.31; for women, RR = 1.37, 95% CI 0.94-2.01). These findings emphasize the importance of AODM prevention and prompt additional investigation of the relation between AODM and dementia.
KW - Alzheimer's disease
KW - amyloid
KW - dementia
KW - diabetes mellitus
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U2 - 10.1093/oxfordjournals.aje.a009106
DO - 10.1093/oxfordjournals.aje.a009106
M3 - Article
C2 - 9054233
AN - SCOPUS:0031050268
SN - 0002-9262
VL - 145
SP - 301
EP - 308
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
IS - 4
ER -