TY - JOUR
T1 - Diabetic Retinopathy Predicts Risk of Alzheimer's Disease
T2 - A Danish Registry-Based Nationwide Cohort Study
AU - Pedersen, Frederik Nørregaard
AU - Stokholm, Lonny
AU - Pouwer, Frans
AU - Hass Rubin, Katrine
AU - Peto, Tunde
AU - Frydkjær-Olsen, Ulrik
AU - Thykjær, Anne Suhr
AU - Andersen, Nis
AU - Andresen, Jens
AU - Bek, Toke
AU - La Cour, Morten
AU - Heegaard, Steffen
AU - Højlund, Kurt
AU - Kawasaki, Ryo
AU - Hajari, Javad Nouri
AU - Ohm Kyvik, Kirsten
AU - Laugesen, Caroline Schmidt
AU - Schielke, Katja Christina
AU - Simó, Rafael
AU - Grauslund, Jakob
PY - 2022
Y1 - 2022
N2 - BACKGROUND: Retinal neurodegeneration is evident in early diabetic retinopathy (DR) which may be associated with other neurodegenerative diseases like Alzheimer's disease (AD).OBJECTIVE: To investigate diabetes and DR as a risk marker of present and incident AD.METHODS: A register-based cohort study was performed. We included 134,327 persons with diabetes above 60 years of age, who had attended DR screening, and 651,936 age- and gender-matched persons without diabetes.RESULTS: At baseline, the prevalence of AD was 0.7% and 1.3% among patients with and without diabetes, respectively. In a multivariable regression model, patients with diabetes were less likely to have AD at baseline (adjusted OR 0.63, 95% CI 0.59-0.68). During follow-up, incident AD was registered for 1473 (0.35%) and 6,899 (0.34%) persons with and without diabetes, respectively. Compared to persons without diabetes, persons with diabetes and no DR had a lower risk to develop AD (adjusted HR 0.87, 95% CI 0.81-0.93), while persons with diabetes and DR had higher risk of AD (adjusted HR 1.24, 95% CI 1.08-1.43). When persons with diabetes and no DR were used as references, a higher risk of incident AD was observed in persons with DR (adjusted HR 1.34, 95% CI 1.18-1.53).CONCLUSION: Individuals with diabetes without DR were less likely to develop AD compared to persons without diabetes. However, individuals with DR had a 34% higher risk of incident AD, which raise the question whether screening for cognitive impairment should be done among individuals with DR.
AB - BACKGROUND: Retinal neurodegeneration is evident in early diabetic retinopathy (DR) which may be associated with other neurodegenerative diseases like Alzheimer's disease (AD).OBJECTIVE: To investigate diabetes and DR as a risk marker of present and incident AD.METHODS: A register-based cohort study was performed. We included 134,327 persons with diabetes above 60 years of age, who had attended DR screening, and 651,936 age- and gender-matched persons without diabetes.RESULTS: At baseline, the prevalence of AD was 0.7% and 1.3% among patients with and without diabetes, respectively. In a multivariable regression model, patients with diabetes were less likely to have AD at baseline (adjusted OR 0.63, 95% CI 0.59-0.68). During follow-up, incident AD was registered for 1473 (0.35%) and 6,899 (0.34%) persons with and without diabetes, respectively. Compared to persons without diabetes, persons with diabetes and no DR had a lower risk to develop AD (adjusted HR 0.87, 95% CI 0.81-0.93), while persons with diabetes and DR had higher risk of AD (adjusted HR 1.24, 95% CI 1.08-1.43). When persons with diabetes and no DR were used as references, a higher risk of incident AD was observed in persons with DR (adjusted HR 1.34, 95% CI 1.18-1.53).CONCLUSION: Individuals with diabetes without DR were less likely to develop AD compared to persons without diabetes. However, individuals with DR had a 34% higher risk of incident AD, which raise the question whether screening for cognitive impairment should be done among individuals with DR.
KW - Alzheimer's disease
KW - cognitive impairment
KW - diabetes mellitus
KW - diabetic retinopathy
KW - Diabetic Retinopathy/epidemiology
KW - Denmark/epidemiology
KW - Humans
KW - Risk Factors
KW - Alzheimer Disease/epidemiology
KW - Registries
KW - Diabetes Mellitus
KW - Cohort Studies
U2 - 10.3233/JAD-215313
DO - 10.3233/JAD-215313
M3 - Journal article
C2 - 35068460
SN - 1387-2877
VL - 86
SP - 451
EP - 460
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
IS - 1
ER -