Vol. 11 nº 4 - Oct/Nov/Dec de 2017
Original Article Páginas: 406 a 412

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

Authors Maria Niures Pimentel dos Santos Matioli1; Claudia Kimie Suemoto2,3; Roberta Diehl Rodriguez1,3; Daniela Souza Farias3; Magnólia Moreira da Silva3; Renata Elaine Paraizo Leite2,3; Renata Eloah Lucena Ferretti-Rebustini3,4; Carlos Augusto Pasqualucci3; Wilson Jacob Filho2,3; Lea Tenenholz Grinberg3; Ricardo Nitrini1,3


keywords: Alzheimer's disease; Diabetes mellitus; vascular dementia; neuropathology; clinicopathologic study.

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.


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