Earlier age of dementia onset and shorter survival times in dementia patients with diabetes

Diabetes is a risk factor for dementia, but relatively little is known about the epidemiology of the association. A retrospective population study using Western Australian hospital inpatient, mental health outpatient, and death records was used to compare the age at index dementia record (proxy for...

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Main Authors: Zilkens, Renate, Davis, W., Spilsbury, Katrina, Semmens, James, Bruce, D.
Format: Journal Article
Published: Oxford University Press 2013
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/10441
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author Zilkens, Renate
Davis, W.
Spilsbury, Katrina
Semmens, James
Bruce, D.
author_facet Zilkens, Renate
Davis, W.
Spilsbury, Katrina
Semmens, James
Bruce, D.
author_sort Zilkens, Renate
building Curtin Institutional Repository
collection Online Access
description Diabetes is a risk factor for dementia, but relatively little is known about the epidemiology of the association. A retrospective population study using Western Australian hospital inpatient, mental health outpatient, and death records was used to compare the age at index dementia record (proxy for onset age) and survival outcomes in dementia patients with and without preexisting diabetes (n = 25,006; diabetes, 17.3%). Inpatient records from 1970 determined diabetes history in this study population with incident dementia in years 1990–2005. Dementia onset and death occurred an average 2.2 years and 2.6 years earlier, respectively, in diabetic compared with nondiabetic patients. Age-specific mortality rates were increased in patients with diabetes. In an adjusted proportional hazard model, the death rate was increased with long-duration diabetes, particularly with early age onset dementia. In dementia diagnosed before age 65 years, those with a ≥15-year history of diabetes died almost twice as fast as those without diabetes (hazard ratio = 1.9, 95% confidence interval: 1.3, 2.9). These results suggest that, in patients with diabetes, dementia onset occurs on average 2 years early and survival outcomes are generally poorer. The effect of diabetes on onset, survival, and mortality is greatest when diabetes develops before middle age and after 15 years’ diabetes duration. The impact of diabetes on dementia becomes progressively attenuated in older age groups.
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spelling curtin-20.500.11937-104412019-02-19T05:34:46Z Earlier age of dementia onset and shorter survival times in dementia patients with diabetes Zilkens, Renate Davis, W. Spilsbury, Katrina Semmens, James Bruce, D. diabetes mellitus proportional hazards models alzheimer disease mortality dementia survival retrospective studies Diabetes is a risk factor for dementia, but relatively little is known about the epidemiology of the association. A retrospective population study using Western Australian hospital inpatient, mental health outpatient, and death records was used to compare the age at index dementia record (proxy for onset age) and survival outcomes in dementia patients with and without preexisting diabetes (n = 25,006; diabetes, 17.3%). Inpatient records from 1970 determined diabetes history in this study population with incident dementia in years 1990–2005. Dementia onset and death occurred an average 2.2 years and 2.6 years earlier, respectively, in diabetic compared with nondiabetic patients. Age-specific mortality rates were increased in patients with diabetes. In an adjusted proportional hazard model, the death rate was increased with long-duration diabetes, particularly with early age onset dementia. In dementia diagnosed before age 65 years, those with a ≥15-year history of diabetes died almost twice as fast as those without diabetes (hazard ratio = 1.9, 95% confidence interval: 1.3, 2.9). These results suggest that, in patients with diabetes, dementia onset occurs on average 2 years early and survival outcomes are generally poorer. The effect of diabetes on onset, survival, and mortality is greatest when diabetes develops before middle age and after 15 years’ diabetes duration. The impact of diabetes on dementia becomes progressively attenuated in older age groups. 2013 Journal Article http://hdl.handle.net/20.500.11937/10441 10.1093/aje/kws387 Oxford University Press fulltext
spellingShingle diabetes mellitus
proportional hazards models
alzheimer disease
mortality
dementia
survival
retrospective studies
Zilkens, Renate
Davis, W.
Spilsbury, Katrina
Semmens, James
Bruce, D.
Earlier age of dementia onset and shorter survival times in dementia patients with diabetes
title Earlier age of dementia onset and shorter survival times in dementia patients with diabetes
title_full Earlier age of dementia onset and shorter survival times in dementia patients with diabetes
title_fullStr Earlier age of dementia onset and shorter survival times in dementia patients with diabetes
title_full_unstemmed Earlier age of dementia onset and shorter survival times in dementia patients with diabetes
title_short Earlier age of dementia onset and shorter survival times in dementia patients with diabetes
title_sort earlier age of dementia onset and shorter survival times in dementia patients with diabetes
topic diabetes mellitus
proportional hazards models
alzheimer disease
mortality
dementia
survival
retrospective studies
url http://hdl.handle.net/20.500.11937/10441