OBJECTIVE We aimed to investigate the differences in clinical characteristics and pharmacological treatment associated with the presence of diabetes in a large cohort of patients with dementia.

RESEARCH DESIGN AND METHODS A cross-sectional registry-based study was conducted using data from the Swedish Dementia Registry (SveDem). Data on dementia diagnosis, dementia type, and demographic determinants were extracted from SveDem. Data from the Swedish Patient Register and Prescribed Drug Register were combined for the diagnosis of diabetes. Data on antidiabetic, dementia, cardiovascular, and psychotropic medications were extracted from the Swedish Prescribed Drug Register. Logistic regression was used to determine whether the variables were associated with diabetes after adjustment for confounders. In total, 29,630 patients were included in the study, and 4,881 (16.5%) of them received a diagnosis of diabetes.

RESULTS In the fully adjusted model, diabetes was associated with lower age at dementia diagnosis (odds ratio [OR] 0.97 [99% CI 0.97–0.98]), male sex (1.41 [1.27–1.55]), vascular dementia (1.17 [1.01–1.36]), and mixed dementia (1.21 [1.06–1.39]). Dementia with Lewy bodies (0.64 [0.44–0.94]), Parkinson disease dementia (0.46 [0.28–0.75]), and treatment with antidepressants (0.85 [0.77–0.95]) were less common among patients with diabetes. Patients with diabetes who had Alzheimer disease obtained significantly less treatment with cholinesterase inhibitors (0.78 [0.63–0.95]) and memantine (0.68 [0.54–0.85]).

CONCLUSIONS Patients with diabetes were younger at dementia diagnosis and obtained less dementia medication for Alzheimer disease, suggesting less optimal dementia treatment. Future research should evaluate survival and differences in metabolic profile in patients with diabetes and different dementia disorders.

目的我们旨在研究大量队列痴呆患者中与糖尿病相关的临床特征和药物治疗的差异。

研究设计和方法使用瑞典痴呆症登记处（SveDem）的数据进行了基于登记的横断面研究。有关痴呆症诊断，痴呆类型和人口统计学决定因素的数据均摘自SveDem。瑞典患者登记簿和处方药登记簿中的数据被合并用于糖尿病的诊断。有关抗糖尿病，痴呆，心血管和精神药物的数据摘自瑞典处方药注册处。校正混杂因素后，使用Logistic回归确定变量是否与糖尿病相关。总共有29,630名患者被纳入研究，其中4,881名（16.5％）被诊断出患有糖尿病。

结果在完全调整的模型中，糖尿病与痴呆症诊断时年龄较低相关（赔率[OR] 0.97 [99％CI 0.97–0.98]），男性（1.41 [1.27–1.55]），血管性痴呆（1.17 [1.01]） –1.36]和混合性痴呆（1.21 [1.06-1.39]）。在糖尿病患者中，路易体痴呆（0.64 [0.44–0.94]），帕金森病痴呆（0.46 [0.28–0.75]）和抗抑郁药治疗（0.85 [0.77–0.95]）在糖尿病患者中较少见。患有阿尔茨海默氏病的糖尿病患者获得的胆碱酯酶抑制剂（0.78 [0.63-0.95]）和美金刚胺（0.68 [0.54-0.85]）的治疗显着减少。

结论糖尿病患者对痴呆症的诊断较年轻，用于阿尔茨海默氏病的痴呆症用药较少，这表明最佳的痴呆症治疗方法较少。未来的研究应评估糖尿病和不同痴呆症患者的生存率和代谢状况的差异。