Author(s): Yaffe K, Falvey CM, Hamilton N, Harris TB, Simonsick EM,
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Abstract IMPORTANCE: Hypoglycemia commonly occurs in patients with diabetes mellitus (DM) and may negatively influence cognitive performance. Cognitive impairment in turn can compromise DM management and lead to hypoglycemia. OBJECTIVE: To prospectively evaluate the association between hypoglycemia and dementia in a biracial cohort of older adults with DM. DESIGN AND SETTING: Prospective population-based study. PARTICIPANTS: We studied 783 older adults with DM (mean age, 74.0 years; 47.0\% of black race/ethnicity; and 47.6\% female) who were participating in the prospective population-based Health, Aging, and Body Composition Study beginning in 1997 and who had baseline Modified Mini-Mental State Examination scores of 80 or higher. MAIN OUTCOME MEASURES: Dementia diagnosis was determined during the follow-up period from hospital records indicating an admission associated with dementia or the use of prescribed dementia medications. Hypoglycemic events were determined during the follow-up period by hospital records. RESULTS: During the 12-year follow-up period, 61 participants (7.8\%) had a reported hypoglycemic event, and 148 (18.9\%) developed dementia. Those who experienced a hypoglycemic event had a 2-fold increased risk for developing dementia compared with those who did not have a hypoglycemic event (34.4\% vs 17.6\%, P < .001; multivariate-adjusted hazard ratio, 2.1; 95\% CI, 1.0-4.4). Similarly, older adults with DM who developed dementia had a greater risk for having a subsequent hypoglycemic event compared with participants who did not develop dementia (14.2\% vs 6.3\%, P < .001; multivariate-adjusted hazard ratio, 3.1; 95\% CI, 1.5-6.6). Further adjustment for stroke, hypertension, myocardial infarction, and cognitive change scores produced similar results. CONCLUSION AND RELEVANCE: Among older adults with DM, there seems to be a bidirectional association between hypoglycemia and dementia.
This article was published in JAMA Intern Med
and referenced in Journal of Neonatal Biology