Microvascular disease and its association with dementia in patients with type 2 diabetes: A nationwide cohort study in Taiwan

Diabetes Obes Metab. 2024 Nov;26(11):5399-5407. doi: 10.1111/dom.15908. Epub 2024 Aug 29.

Abstract

Aim: To assess the likelihood of dementia in individuals with type 2 diabetes (T2D), distinguishing between those with and without microvascular diseases.

Methods: Leveraging the National Health Insurance Research Database in Taiwan, we identified individuals newly diagnosed with T2D from 1 January 2009 through 31 December 2014. Multivariable Cox proportional hazard models were used to compare the risk of outcomes.

Results: Individuals with microvascular disease had a significantly higher risk of all-cause dementia (adjusted hazard ratio [95% confidence interval] 1.13 [1.09, 1.17]) compared with matched individuals without microvascular disease. In addition, individuals with diabetic kidney disease and diabetic neuropathy were associated with a significantly increased risk of Alzheimer's disease (1.16 [1.02, 1.32] and 1.14 [1.03, 1.27]), vascular dementia (1.21 [1.06, 1.38] and 1.14 [1.02, 1.28]) and other dementia (1.11 [1.04, 1.19] and 1.10 [1.04, 1.16]), respectively, compared with those without microvascular disease.

Conclusions: This nationwide cohort study showed that patients with T2D and microvascular disease, particularly diabetic kidney disease and diabetic neuropathy, were associated with a significantly higher risk of Alzheimer's disease, vascular dementia, other dementia and all-cause dementia than those without microvascular disease.

Keywords: Alzheimer's disease; dementia; diabetic kidney disease; diabetic neuropathy; diabetic retinopathy; vascular dementia.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / complications
  • Alzheimer Disease / epidemiology
  • Cohort Studies
  • Databases, Factual
  • Dementia* / epidemiology
  • Dementia* / etiology
  • Dementia, Vascular / epidemiology
  • Dementia, Vascular / etiology
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Diabetic Angiopathies* / epidemiology
  • Diabetic Nephropathies* / complications
  • Diabetic Nephropathies* / epidemiology
  • Diabetic Neuropathies* / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Factors
  • Taiwan / epidemiology