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Publications

Journal Article Ahead of print 1 citation

PubMed: 42472674 DOI: 10.1111/dom.71123

Age of Type 1 Diabetes Onset and Dementia Risk: A Swedish Nationwide, Register-Based Cohort Study.

Diabetes Obes Metab

Authors: Milena Jancev, Björn Eliasson, Geert Jan Biessels, J Hans DeVries, Erik H Serné, Frank L J Visseren, Araz Rawshani, Aidin Rawshani, Tali Cukierman-Yaffe, Naveed Sattar, Hertzel C Gerstein, Thomas T van Sloten

Affiliations

  • Department of Vascular Medicine and Endocrinology, University Medical Center Utrecht, Utrecht, the Netherlands.
  • Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands.
  • Department of Internal Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands.
  • Departement of Clinical & Molecular Medicine, Institute of Medicine, Gothenburg, Sweden.
  • Wallenberg Laboratory for Cardiovascular and Metabolic Research, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
  • Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Epidemiology Department, School of Public Health, Gray Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
  • Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.

Abstract

AIMS

Individuals with Type 1 diabetes are at a higher risk of dementia compared to individuals without diabetes. Younger age at Type 1 diabetes onset has been linked to an increased risk of cardiovascular disease and higher mortality. This study aimed to determine whether younger age at Type 1 diabetes onset was also associated with all-cause dementia.

MATERIALS AND METHODS

This nationwide prospective cohort study used data from individuals with Type 1 diabetes from the Swedish National Diabetes Register. All-cause dementia, including Alzheimer's disease, vascular dementia and non-Alzheimer's-non-vascular dementia, was prospectively ascertained as ICD-10 codes. Age at onset was stratified into < 10 years, 10-17 years and 18-30 years. The 18-30 years group was used as the reference group for all analyses. Cox regression modelling with age as the time-axis, from age at diabetes onset, was deployed to investigate dementia risk.

RESULTS

Of 43 440 included individuals (mean age 33.0 (SD 14.0) years; 44% female), Type 1 diabetes developed before age 10 in 11 776 individuals (27%), between age 10 and 17 in 15 846 (36%) and between 18 and 30 (reference group) in 15 818 (36%). During a median 29.3 [17.6-43.7] years follow-up, 530 (1.2%) developed all-cause dementia. Compared to the reference group, all-cause dementia risk was increased in individuals aged < 10 years at onset (HR 1.37 [95% CI 1.08-1.73]), but not in individuals aged 10-17 years at onset (HR 1.04 [95% CI 0.85-1.26]) (fully adjusted model).

CONCLUSIONS

Type 1 diabetes onset before age 10 is associated with an increased risk of all-cause dementia compared to onset between ages 18 and 30.

MeSH

Diabetes Mellitus, Dementia, Cohort Studies, Dementia, Vascular, Aged, Diabetes Mellitus, Type 1