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

ASSOCIAÇÃO ENTRE DIABETES E CAUSAS DE DEMÊNCIA: EVIDÊNCIA DE UM ESTUDO CLÍNICO-PATOLÓGICO

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.

Key words:
Alzheimer's disease; Diabetes mellitus; vascular dementia; neuropathology; clinicopathologic study

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E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br