Association between glycemic status and all-cause mortality among individuals with dementia: a nationwide cohort study.

IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY Alzheimer's Research & Therapy Pub Date : 2024-08-22 DOI:10.1186/s13195-024-01557-x
Youn Huh, Kye-Yeung Park, Kyungdo Han, Jin-Hyung Jung, Yoon Jeong Cho, Hye Soon Park, Ga Eun Nam, Soo Lim
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Abstract

Background: To examine the association between glycemic status and all-cause mortality risk among individuals with dementia.

Methods: We enrolled 146,832 individuals aged 40 and older with dementia as identified through the Korean National Health Insurance Service health screening test between 2008 and 2016. Mortality status was evaluated at the end of 2019. Participants were classified into normoglycemia, prediabetes, or diabetes mellitus (DM) categories. The duration of diabetes was noted in those with DM. This study focused on the association between glycemic status and all-cause mortality.

Results: The cohort, which was predominantly elderly (average age 75.1 years; 35.5% male), had a 35.2% mortality rate over an average 3.7-year follow-up. DM was linked with increased all-cause mortality risk (hazard ratio [HR] 1.34; 95% confidence interval [CI]: 1.32-1.37) compared to non-DM counterparts. The highest mortality risk was observed in long-term DM patients (≥ 5 years) (HR 1.43; 95% CI: 1.40-1.47), followed by newly diagnosed DM (HR 1.35; 95% CI: 1.30-1.40), shorter-term DM (< 5 years) (HR 1.17; 95% CI: 1.13-1.21), and prediabetes (HR 1.03; 95% CI: 1.01-1.05). These patterns persisted across Alzheimer's disease and vascular dementia, with more pronounced effects observed in younger patients.

Conclusions: Glucose dysregulation in dementia significantly increased mortality risk, particularly in newly diagnosed or long-standing DM. These findings suggest the potential benefits of maintaining normal glycemic levels in improving the survival of patients with dementia.

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痴呆症患者的血糖状况与全因死亡率之间的关系:一项全国性队列研究。
背景:研究老年痴呆症患者的血糖状况与全因死亡风险之间的关系:研究痴呆症患者的血糖状况与全因死亡风险之间的关系:方法:我们在 2008 年至 2016 年间招募了 146,832 名 40 岁及以上的痴呆症患者,这些患者是通过韩国国民健康保险服务健康筛查测试确定的。在 2019 年底对死亡率状况进行了评估。参与者被分为正常血糖、糖尿病前期或糖尿病(DM)类别。糖尿病患者的糖尿病持续时间也被记录在案。这项研究的重点是血糖状况与全因死亡率之间的关系:研究对象主要为老年人(平均年龄 75.1 岁;35.5% 为男性),在平均 3.7 年的随访中,死亡率为 35.2%。与非糖尿病患者相比,糖尿病增加了全因死亡风险(危险比 [HR] 1.34;95% 置信区间 [CI]:1.32-1.37)。长期糖尿病患者(≥ 5 年)的死亡风险最高(HR 1.43;95% 置信区间:1.40-1.47),其次是新诊断的糖尿病患者(HR 1.35;95% 置信区间:1.30-1.40)、短期糖尿病患者(结论:新诊断的糖尿病患者死亡风险最高,其次是短期糖尿病患者):痴呆症患者的血糖失调会显著增加死亡风险,尤其是新诊断的或病程较长的糖尿病患者。这些研究结果表明,维持正常的血糖水平对提高痴呆症患者的生存率具有潜在的益处。
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来源期刊
Alzheimer's Research & Therapy
Alzheimer's Research & Therapy 医学-神经病学
CiteScore
13.10
自引率
3.30%
发文量
172
审稿时长
>12 weeks
期刊介绍: Alzheimer's Research & Therapy is an international peer-reviewed journal that focuses on translational research into Alzheimer's disease and other neurodegenerative diseases. It publishes open-access basic research, clinical trials, drug discovery and development studies, and epidemiologic studies. The journal also includes reviews, viewpoints, commentaries, debates, and reports. All articles published in Alzheimer's Research & Therapy are included in several reputable databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, MEDLINE, PubMed, PubMed Central, Science Citation Index Expanded (Web of Science) and Scopus.
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