Association between diabetes and causes of dementia: Evidence from a clinicopathological study

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posted on 2018-01-10, 05:56 authored by Maria Niures Pimentel dos Santos Matioli, Claudia Kimie Suemoto, Roberta Diehl Rodriguez, Daniela Souza Farias, Magnólia Moreira da Silva, Renata Elaine Paraizo Leite, Renata Eloah Lucena Ferretti-Rebustini, Carlos Augusto Pasqualucci, Wilson Jacob Filho, Lea Tenenholz Grinberg, Ricardo Nitrini

ABSTRACT. Background: Diabetes mellitus is a risk factor for dementia, especially for vascular dementia (VaD), but there is no consensus on diabetes as a risk factor for Alzheimer's disease (AD) and other causes of dementia. Objective: To explore the association between diabetes and the neuropathological etiology of dementia in a large autopsy study. Methods: Data were collected from the participants of the Brain Bank of the Brazilian Aging Brain Study Group between 2004 and 2015. Diagnosis of diabetes was reported by the deceased's next-of-kin. Clinical dementia was established when CDR ≥ 1 and IQCODE > 3.41. Dementia etiology was determined by neuropathological examination using immunohistochemistry. The association of diabetes with odds of dementia was investigated using multivariate logistic regression. Results: We included 1,037 subjects and diabetes was present in 279 participants (27%). The prevalence of dementia diagnosis was similar in diabetics (29%) and non-diabetics (27%). We found no association between diabetes and dementia (OR = 1.22; 95%CI = 0.81-1.82; p = 0.34) on the multivariate analysis. AD was the main cause of dementia in both groups, while VaD was the second-most-frequent cause in diabetics. Other mixed dementia was the second-most-common cause of dementia and more frequent among non-diabetics (p = 0.03). Conclusion: Diabetes was not associated with dementia in this large clinicopathological study.