TY - JOUR
T1 - Glucose tolerance status and risk of dementia in the community
T2 - The Hisayama Study
AU - Ohara, T.
AU - Doi, Y.
AU - Ninomiya, T.
AU - Hirakawa, Yoichiro
AU - Hata, J.
AU - Iwaki, Toru
AU - Kanba, Shigenobu
AU - Kiyohara, Y.
N1 - Funding Information:
Dr. Ohara, Dr. Doi, Dr. Ninomiya, Dr. Hirakawa, and Dr. Hata report no disclosures. Dr. Iwaki serves as an editorial board member of Neuropathology, Brain Tumor Pathology, and Pathology-Research and Practice and is funded by a Grant-in-Aid for Scientific Research (B) from Japan Society for the Promotion of Science (JSPS). Dr. Kanba serves as a scientific board member of Astellas Pharma Inc. and an editorial board member of Molecular Psychiatry, Journal of Neuroscience and Psychiatry, Asian Journal of Psychiatry, and Asia Pacific Journal of Psychiatry; has received honoraria from Eli Lilly and Company, GlaxoSmithKline, Pfizer Inc, Asahi Kasei Kuraray Medical Co., Ltd., and Shionogi & Co., Ltd.; and receives research support from Ono Pharmaceutical Co. Ltd. and Grant from Japanese Ministry of Education and of Health. Dr. Kiyohara is funded by a Health and Labour Sciences Research Grant of the Ministry of Health, Labour and Welfare of Japan (Comprehensive Research on Aging and Health: H20-Chouju-004).
Funding Information:
Study funding: Supported in part by Grants-in-Aid for Scientific Research ( nos. 20591063, 21590698, 22590892, and 22300116 ) from the Ministry of Education, Culture, Sports, Science and Technology of Japan, and a Health and Labour Sciences Research Grant of the Ministry of Health, Labour and Welfare of Japan (Comprehensive Research on Aging and Health: H20-Chouju-004).
PY - 2011/9/20
Y1 - 2011/9/20
N2 - Objective: We investigated the association between glucose tolerance status defined by a 75-g oral glucose tolerance test (OGTT) and the development of dementia. Methods: A total of 1,017 community-dwelling dementia-free subjects aged ≥60 years who underwent the OGTT were followed up for 15 years. Outcome measure was clinically diagnosed dementia. Results: The age- and sex-adjusted incidence of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD) were significantly higher in subjects with diabetes than in those with normal glucose tolerance. These associations remained robust even after adjustment for confounding factors for all-cause dementia and AD, but not for VaD (all-cause dementia: adjusted hazard ratio [HR] = 1.74, 95% confidence interval [CI] = 1.19 to 2.53, p = 0.004; AD: adjusted HR = 2.05, 95% CI = 1.18 to 3.57, p = 0.01; VaD: adjusted HR = 1.82, 95% CI = 0.89 to 3.71, p = 0.09). Moreover, the risks of developing all-cause dementia, AD, and VaD significantly increased with elevated 2-hour postload glucose (PG) levels even after adjustment for covariates, but no such associations were observed for fasting plasma glucose (FPG) levels: compared with those with 2-hour PG levels of <6.7 mmol/L, the multivariable-adjusted HRs of all-cause dementia and AD significantly increased in subjects with 2-hour PG levels of 7.8 to 11.0 mmol/L or over, and the risk of VaD was significantly higher in subjects with levels of ≥11.1 mmol/L. Conclusions: Our findings suggest that diabetes is a significant risk factor for all-cause dementia, AD, and probably VaD. Moreover, 2-hour PG levels, but not FPG levels, are closely associated with increased risk of all-cause dementia, AD, and VaD.
AB - Objective: We investigated the association between glucose tolerance status defined by a 75-g oral glucose tolerance test (OGTT) and the development of dementia. Methods: A total of 1,017 community-dwelling dementia-free subjects aged ≥60 years who underwent the OGTT were followed up for 15 years. Outcome measure was clinically diagnosed dementia. Results: The age- and sex-adjusted incidence of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD) were significantly higher in subjects with diabetes than in those with normal glucose tolerance. These associations remained robust even after adjustment for confounding factors for all-cause dementia and AD, but not for VaD (all-cause dementia: adjusted hazard ratio [HR] = 1.74, 95% confidence interval [CI] = 1.19 to 2.53, p = 0.004; AD: adjusted HR = 2.05, 95% CI = 1.18 to 3.57, p = 0.01; VaD: adjusted HR = 1.82, 95% CI = 0.89 to 3.71, p = 0.09). Moreover, the risks of developing all-cause dementia, AD, and VaD significantly increased with elevated 2-hour postload glucose (PG) levels even after adjustment for covariates, but no such associations were observed for fasting plasma glucose (FPG) levels: compared with those with 2-hour PG levels of <6.7 mmol/L, the multivariable-adjusted HRs of all-cause dementia and AD significantly increased in subjects with 2-hour PG levels of 7.8 to 11.0 mmol/L or over, and the risk of VaD was significantly higher in subjects with levels of ≥11.1 mmol/L. Conclusions: Our findings suggest that diabetes is a significant risk factor for all-cause dementia, AD, and probably VaD. Moreover, 2-hour PG levels, but not FPG levels, are closely associated with increased risk of all-cause dementia, AD, and VaD.
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U2 - 10.1212/WNL.0b013e31822f0435
DO - 10.1212/WNL.0b013e31822f0435
M3 - Article
C2 - 21931106
AN - SCOPUS:80555157642
VL - 77
SP - 1126
EP - 1134
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 12
ER -