American Diabetes Association
Online-Only_Supplemental_Material_Diabetes-dementia_20210801.pdf (268.36 kB)

Risk of Incident Dementia According to Glycemic Status and Comorbidities of Hyperglycemia: A Nationwide Population-Based Cohort Study

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posted on 2021-10-28, 22:27 authored by Woo Jung Kim, Seo Jung Lee, Eun Lee, Eun Young Lee, Kyungdo Han
Objective: To investigate the risk of incident dementia according to fasting glucose levels and presence of comorbidities.

Research Design and Methods: Using a health insurance claims database and the results of biennial health examinations in South Korea, we selected 8,400,950 subjects aged ≥40 years who underwent health examinations in 2009–2010. We followed them until 2016. Subjects’ baseline characteristics were categorized by presence of diabetes (yes/no) and glycemic status (normoglycemia/impaired fasting glucose (IFG)/new-onset diabetes/known diabetes (duration <5 years or ≥5 years). We estimated adjusted hazard ratios (aHRs) for dementia occurrence in each category.

Results: During the observation period of 48,323,729 person-years, all-cause dementia developed in 353,392 (4.2%) subjects. Compared with normoglycemia, aHRs (95% confidence interval) were 1.01 (1.01–1.02) in IFG, 1.45 (1.44–1.47) in new-onset diabetes, 1.32 (1.30–1.33) in known diabetes <5 years, and 1.62 (1.60–1.64) in known diabetes ≥5 years. We found that associations between ischemic heart disease and chronic kidney disease with incident dementia were affected by the presence of diabetes. Ischemic stroke showed a greater association with incident dementia than diabetes.

Conclusions: Mild degrees of hyperglycemia and presence of comorbidities were associated with incident dementia. Intervention during the prodromal stage of a chronic disease (e.g., prediabetes) could be considered for dementia prevention.


This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2020-0148).


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