Type 2 Diabetes Diagnosis at Younger Age Linked with Increased Dementia Risk
A study found that patients with obesity who were diagnosed with type 2 diabetes aged 50 or younger had the highest risk of dementia.
Individuals who are diagnosed with type 2 diabetes (T2D) at a younger age are at an increased risk of developing dementia, according to research published in the journal PLoS ONE.1 Because the risk was seen particularly in patients with obesity, authors of the study said interventions that target obesity may be more effective in preventing dementia in this population.
Type 2 Diabetes Diagnosis at Younger Age Linked with Increased Dementia Risk / Caphira Lescante - stock.adobe.com
In the United States, over 38 million people have diabetes and between 90% to 95% of cases are T2D. Each year, nearly 5300 youths are diagnosed with T2D, which leads to an increased risk of heart disease, kidney disease, nerve damage, blindness, and many other conditions. Although there are certain risk factors for T2D—including having a family history of the disease—most cases can be prevented though lifestyle factors like a healthy diet and exercise.2
READ MORE: Self-Efficacy Linked with Greater Diabetes Control in Adolescents
“Obesity and diabetes are significant risk factors for developing dementia because key mediators of dementia progression are inflammation, oxidative stress, and cerebrovascular disease within the brain that contribute to neuronal dysfunction and death,” the authors wrote. “It is hypothesized that obesity is not a primary risk factor for diminished cognitive functioning, but exacerbates the effects of cardiovascular risk factors on cognition. However, studies investigating the effect of obesity on the association between age at diagnosis of T2DM and dementia are limited.”
Investigators from New York University and East Carolina University conducted a study to assess the association between age at T2D diagnosis and later dementia risk, as well as to determine if obesity moderated the relationship. Data for the study was gathered from the Health and Retirement Study, a longitudinal study that surveys a representative sample of approximately 20,000 people in the US. That data was matched with the study’s 2003 Diabetes Mail-Out Survey.
The new study’s cohort included 1213 patients with T2D aged 50 or older who did not have a dementia diagnosis. Age at diabetes diagnosis was divided into 4 categories: younger than 50 years, 50 to 59 years, 60 to 69 years, and 70 years or older. BMI was calculated via self-reported bodyweight divided by the square of the self-reported body height. Obesity was defined as a BMI of 30.0 kg/m2 or more. Dementia was determined by a modified version of the Telephone Interview for Cognitive Status.
Of the patients, 262 were diagnosed with T2D at 50 years or younger; 378 at 50 to 59 years; 419 at 60 to 69 years; and 154 at 70 or more years. Patients diagnosed at a younger age were more likely to be female, a current smoker, have a higher BMI, poorer glycemic control and be a racial or ethnic minority. Investigators found that 216 patients developed dementia during 10 years of follow-up. Compared with patients diagnosed with T2D at 70 years or older, being diagnosed at a younger age was associated with an increased risk of dementia. The association was strongest in patients diagnosed at 50 years or younger, with a 201% increased risk.
Additionally, 46.7% of the patients had obesity. Compared to patients who did not have obesity and were diagnosed with T2D aged 50 or older, patients with obesity who were diagnosed with T2D aged 50 or younger had the highest risk of dementia.
“While we do not know for sure why an earlier diabetes diagnosis would increase the risk for dementia, prior studies show that people diagnosed with type 2 diabetes in mid-life may experience more vascular complications, poor blood sugar control, and insulin resistance—all of which are known risk factors for cognitive impairment,” Bei Wu, senior author on the study, said in a release.3 “Our study highlights the importance of one’s age at diabetes diagnosis and suggests that specifically targeting obesity—whether through diet and exercise or perhaps medication—may play a role in staving off dementia in younger adults with diabetes.”
READ MORE: Diabetes Resource Center
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