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Risk of Alzheimer's Disease in People with Diabetes Mellitus

Muhammad Umer Zaheer Khan1, Abdul Raheem Tunio2, Shafaque Batool3, Kausar Abbas Saldera4, Rizwan Lakho5, ,Ufaque Batool K. Samo4*, Jehan Zaib Arshad6

Background: Diabetes Mellitus (DM) may increase the risk of Alzheimer’s disease (AD) in a number of biologically conceivable ways, although how DM and the development of AD are related is still unclear.

Objective: To assess the risk of AD in subjects with and without DM.

Design: Prospective community-based cohort study.

Participants: Framingham Research Participants (n=2210; 1325 women; mean age, 70 years) who were part of the first cohort, did not have dementia and did not participate in the biennial test.

Results: Relative risk of incident Alzheimer’s disease within the overall group and within subgroups defined by plasma homocysteine levels and apolipoprotein E genotype (based on criteria from the National Institute of Neurological and Communicative Diseases and Stroke/Association for Alzheimer’s Disease and Related Disorders); models were adjusted for age, sex, and cardiovascular risk factors. At baseline, 202 people (9.1%) had DM. During the follow-up period (mean, 12.7 years; range, 1-20 years), the risk of developing AD was 1.15 (95% confidence interval, 0.65-2.05) in 17 of 202 people with diabetes (8.1%) and 220 of 2008 people without diabetes (11.0%). Among the 684 participants, 44 (6.4%) did not have elevated plasma homocysteine levels or an apolipoprotein E4 allele; the relative risk of AD was 2.98 (95% confidence interval, 1.06-8.39; P=.03) in patients with diabetes compared to those without diabetes. The effect was greatest among individuals 75 years of age or older, with a relative risk of 4.77 (95% confidence interval, 1.28–17.72; P=.02).

Conclusion: Overall, Diabetes Mellitus did not increase the incidence of incident AD in the Framingham cohort; however, in the absence of other major risk factors for AD, Diabetes Mellitus may be a risk factor for AD.