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Association Between Age at Diabetes Onset and Subsequent Risk of Dementia

Barbiellini Amidei, Claudio ; Fayosse, Aurore ; Dumurgier, Julien ; Machado-Fragua, Marcos D ; Tabak, Adam G ; van Sloten, Thomas ; Kivimäki, Mika ; Dugravot, Aline ; Sabia, Séverine ; Singh-Manoux, Archana

JAMA : the journal of the American Medical Association, 2021-04, Vol.325 (16), p.1640-1649 [Periódico revisado por pares]

United States: American Medical Association

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Título:
Association Between Age at Diabetes Onset and Subsequent Risk of Dementia
Autor: Barbiellini Amidei, Claudio ; Fayosse, Aurore ; Dumurgier, Julien ; Machado-Fragua, Marcos D ; Tabak, Adam G ; van Sloten, Thomas ; Kivimäki, Mika ; Dugravot, Aline ; Sabia, Séverine ; Singh-Manoux, Archana
Assuntos: Adult ; Age ; Age factors in disease ; Age of Onset ; Cohort Studies ; Complications ; Complications and side effects ; Dementia ; Dementia - epidemiology ; Dementia - etiology ; Dementia disorders ; Development and progression ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - complications ; Electronic health records ; Electronic medical records ; Female ; Health risks ; Humans ; Life Sciences ; Male ; Middle Aged ; Multivariate Analysis ; Observations ; Original Investigation ; Population studies ; Pregnancy ; Risk Factors ; Type 2 diabetes ; United Kingdom - epidemiology
É parte de: JAMA : the journal of the American Medical Association, 2021-04, Vol.325 (16), p.1640-1649
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
PMCID: PMC8080220
Descrição: IMPORTANCE: Trends in type 2 diabetes show an increase in prevalence along with younger age of onset. While vascular complications of early-onset type 2 diabetes are known, the associations with dementia remains unclear. OBJECTIVE: To determine whether younger age at diabetes onset is more strongly associated with incidence of dementia. DESIGN, SETTING, AND PARTICIPANTS: Population-based study in the UK, the Whitehall II prospective cohort study, established in 1985-1988, with clinical examinations in 1991-1993, 1997-1999, 2002-2004, 2007-2009, 2012-2013, and 2015-2016, and linkage to electronic health records until March 2019. The date of final follow-up was March 31, 2019. EXPOSURES: Type 2 diabetes, defined as a fasting blood glucose level greater than or equal to 126 mg/dL at clinical examination, physician-diagnosed type 2 diabetes, use of diabetes medication, or hospital record of diabetes between 1985 and 2019. MAIN OUTCOMES AND MEASURES: Incident dementia ascertained through linkage to electronic health records. RESULTS: Among 10 095 participants (67.3% men; aged 35-55 years in 1985-1988), a total of 1710 cases of diabetes and 639 cases of dementia were recorded over a median follow-up of 31.7 years. Dementia rates per 1000 person-years were 8.9 in participants without diabetes at age 70 years, and rates were 10.0 per 1000 person-years for participants with diabetes onset up to 5 years earlier, 13.0 for 6 to 10 years earlier, and 18.3 for more than 10 years earlier. In multivariable-adjusted analyses, compared with participants without diabetes at age 70, the hazard ratio (HR) of dementia in participants with diabetes onset more than 10 years earlier was 2.12 (95% CI, 1.50-3.00), 1.49 (95% CI, 0.95-2.32) for diabetes onset 6 to 10 years earlier, and 1.11 (95% CI, 0.70-1.76) for diabetes onset 5 years earlier or less; linear trend test (P < .001) indicated a graded association between age at onset of type 2 diabetes and dementia. At age 70, every 5-year younger age at onset of type 2 diabetes was significantly associated with an HR of dementia of 1.24 (95% CI, 1.06-1.46) in analyses adjusted for sociodemographic factors, health behaviors, and health-related measures. CONCLUSIONS AND RELEVANCE: In this longitudinal cohort study with a median follow-up of 31.7 years, younger age at onset of diabetes was significantly associated with higher risk of subsequent dementia.
Editor: United States: American Medical Association
Idioma: Inglês

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Association Between Age at Diabetes Onset and Subsequent Risk of Dementia

Barbiellini Amidei, Claudio ; Fayosse, Aurore ; Dumurgier, Julien ; Machado-Fragua, Marcos D ; Tabak, Adam G ; van Sloten, Thomas ; Kivimäki, Mika ; Dugravot, Aline ; Sabia, Séverine ; Singh-Manoux, Archana

United States: American Medical Association

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