AbstractIntroductionDiabetes is a well‐established risk factor for dementia, but its impact on the prodromal phase of dementia is unclear.MethodsCohorts of older adults who were cognitively healthy (n = 1840) or had cognitive impairment‐no dementia (CIND; n = 682) were followed over 12 years to detect incident CIND and dementia, respectively.ResultsPoorly controlled diabetes (glycated hemoglobin [HbA1c] ≥7.5%; reference = normoglycemia) was associated with double the risk of CIND (Cox regression multi‐adjusted hazard ratio [HR] 2.01, 95% confidence interval [CI] 1.13‐3.58) and triple the risk CIND progressing to dementia (HR 2.87, 95% CI 1.20‐6.85). Co‐morbid diabetes and heart disease doubled the risk of incident CIND and dementia, although neither disease conferred a significant risk of either outcome alone. Elevated systemic inflammation contributed to the diabetes‐associated increased dementia risk.ConclusionsDiabetes characterized by poor glycemic control or cardiovascular complications is related to a greater risk of the development and progression of cognitive impairment. Inflammation may play a role in these relationships.

中文翻译：

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糖尿病对认知障碍及其进展为痴呆的影响

摘要介绍糖尿病是痴呆症的一个公认的危险因素，但其对痴呆症前驱期的影响尚不清楚。方法对认知健康 (n = 1840) 或患有认知障碍 - 无痴呆 (CIND; n = 682) 的老年人群体进行了 12 年以上的随访，以分别检测 CIND 和痴呆事件。结果糖尿病控制不佳（糖化血红蛋白 [HbA1c] ≥7.5%；参考值 = 血糖正常）与 CIND 风险加倍相关（Cox 回归多重调整风险比 [HR] 2.01，95% 置信区间 [CI] 1.13‐3.58），并且CIND 进展为痴呆的风险增加三倍（HR 2.87，95% CI 1.20‐6.85）。糖尿病和心脏病共病使发生 CIND 和痴呆的风险增加了一倍，尽管这两种疾病单独导致任一结果的风险均不显着。全身炎症升高导致与糖尿病相关的痴呆风险增加。结论以血糖控制不佳或心血管并发症为特征的糖尿病与认知障碍发生和进展的更大风险有关。炎症可能在这些关系中发挥作用。