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Neurology 1999;53:1937
© 1999 American Academy of Neurology
Articles

Diabetes mellitus and the risk of dementia

The Rotterdam Study

A. Ott, MD, PhD, R. P. Stolk, MD, PhD, F. van Harskamp, MD, H. A. P. Pols, MD, PhD, A. Hofman, MD, PhD and M. M. B. Breteler, MD, PhD

From the Departments of Epidemiology & Biostatistics (Drs. Ott, Stolk, Hofman, and Breteler), Medical Microbiology (Dr. Ott), Neurology (Dr. van Harskamp), and Internal Medicine III, Erasmus University Medical School (Dr. Pols), Rotterdam; and Julius Centre for Patient Oriented Research (Dr. Stolk), Utrecht University, Utrecht, the Netherlands.

Address correspondence and reprint requests to Dr. Alewijn Ott, Department of Epidemiology & Biostatistics, Erasmus University Medical School, PO Box 1738, 3000 DR Rotterdam, the Netherlands.

OBJECTIVE: To determine the influence of type 2 diabetes mellitus on the risk of dementia and AD.

BACKGROUND: Both dementia and diabetes are frequent disorders in elderly people.

METHODS: Prospective population-based cohort study among 6,370 elderly subjects. At baseline study participants were examined for presence of diabetes mellitus. Nondemented participants were followed up, on average, for 2.1 years. Incident dementia was diagnosed using a three-step screening and comprehensive diagnostic workup. To complete the follow-up, medical files were studied of persons who could not be reexamined. We estimated relative risks with proportional hazard regression, adjusting for age, sex, and possible confounders.

RESULTS: During the follow-up, 126 patients became demented, of whom 89 had AD. Diabetes mellitus almost doubled the risk of dementia (relative risk [RR] 1.9 [1.3 to 2.8]) and AD (RR 1.9 [1.2 to 3.1]). Patients treated with insulin were at highest risk of dementia (RR 4.3 [1.7 to 10.5]).

CONCLUSION: The diabetes attributable risk for dementia of 8.8% suggests that diabetes may have contributed to the clinical syndrome in a substantial proportion of all dementia patients.

Key words: AD—Dementia—Diabetes mellitus—Epidemiology—Incidence.




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