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Higher vascular dementia risk in women with diabetes

Higher vascular dementia risk in women with diabetes

Publication date: Wednesday, 23 March 2016
Contributor(s): Jeremy Bray

Women with diabetes at greater risk of vascular dementia than men

A large systematic review of 14 studies including >2 million people shows that people with diabetes are 60% more likely to develop dementia than those without diabetes. In addition, women with diabetes appear to be at even higher risk of developing vascular dementia than men.

A comprehensive literature search identified 1495 studies between January 2011 and November 2014 that had reported on the association between diabetes and dementia.  The majority of the studies were excluded for reasons including lack of primary data, single sex population, and non-prospective study design. Subsequent full text evaluation of the remaining 70 studies resulted in 14 high quality studies from the US, UK, Far East and Scandinavian countries fitting the study criteria.

As expected from previous studies, diabetes was significantly associated with dementia in both sexes. Non-vascular dementia (mainly Alzheimer’s disease) was also 50% more likely to develop in men and women with type 2 diabetes.

Interestingly, the risk of vascular dementia was higher in women (RR 2.34 [95% CI 1.86–2.94] in women and 1.73 [95% CI 1.61–1.85] in men). Overall, women with diabetes had a 19% (95% CI 8-30%, p more than 0.001) greater excess risk for vascular dementia compared with men with diabetes.

Key results from the meta-analysis
  • Diabetes was associated with a 60% increased risk of any dementia in both sexes (women: pooled RR 1.62 [95% CI 1.45–1.80]; men: pooled RR 1.58 [95% CI 1.38–1.81]).
  • The diabetes-associated relative risks for vascular dementia were 2.34 (95% CI 1.86–2.94) in women and 1.73 (95% CI 1.61–1.85) in men.
  • The RRs for nonvascular dementia (mainly Alzheimer’s disease) were 1.53 (95% CI 1.35–1.73) in women and 1.49 (95% CI 1.31–1.69) in men.
  • Overall, women with diabetes had a 19% greater risk for the development of vascular dementia than men (multiple-adjusted ratio of relative risks 1.19 [95% CI 1.08–1.30]; P more than 0.001).

Chatterjee S, et al. Type 2 diabetes as a risk factor for dementia in women compared with men: a pooled analysis of 2.3 million people comprising more than 100,000 cases of dementia. Diabetes Care 2015, published online 17 December, doi: 10.233/dc15-1588

ACTION

This study highlights the role of type 2 diabetes in the aetiology of dementia, and gives further support for the hypothesis of greater adverse consequences of diabetes in women.  These data should provide increased motivation to focus on early prevention of diabetes in both women and men.

Topics covered:
Category: Evidence in Practice
Edition: Volume 1, Number 3, BJPCN Online 2016
Contributor(s): Jeremy Bray

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