Long-term impact of type 2 diabetes onset on dementia incidence rate among New Zealanders with impaired glucose tolerance: A tapered-matched landmark analysis over 25 years

Yu, Dahai; Wang, Zheng; Osuagwu, Uchechukwu Levi; Pickering, Karen; Baker, John; Cutfield, Richard; Cai, Yamei; Orr-Walker, Brandon J; Sundborn, Gerhard; Qu, Bingjie; Zhao, Zhanzheng; Simmons, David

Abstract

INTRODUCTION
We aimed to investigate the association between the onset of type 2 diabetes (T2D) and dementia incidence rates (IR) in the population with impaired glucose tolerance (IGT) identified in primary care in New Zealand (NZ) over 25 years.

METHODS
Tapered matching and landmark analysis (accounting for immortal bias) were used to control for potential effects of known confounders. The association between T2D onset and 5- and 10-year IR of dementia was estimated by weighted Cox models.

RESULTS
The onset of T2D was significantly associated with the 10-year IR of dementia, especially in the socioeconomically deprived, those of non-NZ European ethnicity, those currently smoking, and patients with higher metabolic measures.

DISCUSSION
Our findings suggest that the onset of T2D is a significant risk factor for dementia in individuals with IGT. Dementia screening and structured diabetes prevention are vital in the population with IGT, particularly those from deprived or ethnic minority backgrounds.

Highlights
Increased dementia incidence rate links with T2D onset in people with IGT.
Significant incidence varied by ethnicity, socioeconomic status, and health factors.
Results emphasize the diabetes manage and socioeconomic factors on dementia risk.
Secondary analysis highlights the key role of vascular health in dementia prevention.

Citation

Yu, D., Wang, Z., Osuagwu, U. L., Pickering, K., Baker, J., Cutfield, R., …Simmons, D. (2024). Long-term impact of type 2 diabetes onset on dementia incidence rate among New Zealanders with impaired glucose tolerance: A tapered-matched landmark analysis over 25 years. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, https://doi.org/10.1002/alz.13855

• Journal Article Type: Article
• Acceptance Date: Mar 29, 2024
• Online Publication Date: Jun 14, 2024
• Publication Date: Jun 14, 2024
• Deposit Date: Jun 17, 2024
• Publicly Available Date: Jun 17, 2024
• Journal: Alzheimer's & Dementia: The Journal of the Alzheimer's Association
• Print ISSN: 1552-5260
• Electronic ISSN: 1552-5279
• Publisher: Wiley Open Access
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1002/alz.13855
• Keywords: type 2 diabetes, landmark analysis, impaired glucose tolerance, tapered matching, dementia
• Public URL: https://keele-repository.worktribe.com/output/850197
• Publisher URL: https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13855