AIMS/HYPOTHESIS Diabetes is associated with an increased risk of dementia. We estimated the potential impact of trends in diabetes prevalence upon mortality and the future burden of dementia and disability in England and Wales. METHODS We used a probabilistic multi-state, open cohort Markov model to integrate observed trends in diabetes, cardiovascular disease and dementia to forecast the occurrence of disability and dementia up to the year 2060. Model input data were taken from the English Longitudinal Study of Ageing, Office for National Statistics vital data and published effect estimates for health-state transition probabilities. The baseline scenario corresponded to recent trends in obesity: a 26% increase in the number of people with diabetes by 2060. This scenario was evaluated against three alternative projected trends in diabetes: increases of 49%, 20% and 7%. RESULTS Our results suggest that changes in the trend in diabetes prevalence will lead to changes in mortality and incidence of dementia and disability, which will become visible after 10-15 years. If the relative prevalence of diabetes increases 49% by 2060, expected additional deaths would be approximately 255,000 (95% uncertainty interval [UI] 236,000-272,200), with 85,900 (71,500-101,600) cumulative additional cases of dementia and 104,900 (85,900-125,400) additional cases of disability. With a smaller relative increase in diabetes prevalence (7% increase by 2060), we estimated 222,200 (205,700-237,300) fewer deaths, and 77,000 (64,300-90,800) and 93,300 (76,700-111,400) fewer additional cases of dementia and disability, respectively, than the baseline case of a 26% increase in diabetes. CONCLUSIONS/INTERPRETATION Reducing the burden of diabetes could result in substantial reductions in the incidence of dementia and disability over the medium to long term.

中文翻译：

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糖尿病预防对死亡率以及痴呆和残疾的未来负担的潜在影响：一项模型研究。

目的/假设糖尿病与痴呆症的风险增加有关。我们估计了糖尿病流行趋势对英格兰和威尔士的死亡率以及痴呆和残疾的未来负担的潜在影响。方法我们采用概率多状态开放队列马尔可夫模型，对观察到的糖尿病，心血管疾病和痴呆趋势进行整合，以预测直至2060年残疾和痴呆的发生。模型输入数据取自英语纵向老龄化研究，国家统计局的重要数据和已发布的健康状态转换概率估计值。基线情景与肥胖症的近期趋势相对应：到2060年，糖尿病患者人数增加26％。针对三种其他的糖尿病预测趋势，对该情景进行了评估：分别增长49％，20％和7％。结果我们的结果表明，糖尿病患病率趋势的变化将导致死亡率以及痴呆和残疾发生率的变化，这将在10-15年后显现出来。如果到2060年，糖尿病的相对患病率增加49％，则预期的额外死亡人数将约为255,000（95％不确定区间[UI] 236,000-272,200），其中累计有85,900（71,500-101,600）痴呆症患者和104,900（85,900-125,400） ）其他伤残案件。随着糖尿病患病率的相对增加幅度较小（到2060年增加7％），我们估计死亡人数减少了222,200（205,700-237,300），痴呆症和残障病例分别减少了77,000（64,300-90,800）和93,300（76,700-111,400） ，比基准病例增加了26％的糖尿病。