Biology and Medicine

Abstrait

Risk of Alzheimer's Disease in People with Diabetes Mellitus

Muhammad Umer Zaheer Khan1, Abdul Raheem Tunio2, Shafaque Batool3, Kausar Abbas Saldera4, Rizwan Lakho5, ,Ufaque Batool K. Samo4*, Jehan Zaib Arshad6

Background: Diabetes Mellitus (DM) may increase the risk of Alzheimer’s disease (AD) in a number of biologically conceivable ways, although how DM and the development of AD are related is still unclear.

Objective: To assess the risk of AD in subjects with and without DM.

Design: Prospective community-based cohort study.

Participants: Framingham Research Participants (n=2210; 1325 women; mean age, 70 years) who were part of the first cohort, did not have dementia and did not participate in the biennial test.

Results: Relative risk of incident Alzheimer’s disease within the overall group and within subgroups defined by plasma homocysteine levels and apolipoprotein E genotype (based on criteria from the National Institute of Neurological and Communicative Diseases and Stroke/Association for Alzheimer’s Disease and Related Disorders); models were adjusted for age, sex, and cardiovascular risk factors. At baseline, 202 people (9.1%) had DM. During the follow-up period (mean, 12.7 years; range, 1-20 years), the risk of developing AD was 1.15 (95% confidence interval, 0.65-2.05) in 17 of 202 people with diabetes (8.1%) and 220 of 2008 people without diabetes (11.0%). Among the 684 participants, 44 (6.4%) did not have elevated plasma homocysteine levels or an apolipoprotein E4 allele; the relative risk of AD was 2.98 (95% confidence interval, 1.06-8.39; P=.03) in patients with diabetes compared to those without diabetes. The effect was greatest among individuals 75 years of age or older, with a relative risk of 4.77 (95% confidence interval, 1.28–17.72; P=.02).

Conclusion: Overall, Diabetes Mellitus did not increase the incidence of incident AD in the Framingham cohort; however, in the absence of other major risk factors for AD, Diabetes Mellitus may be a risk factor for AD.