Diabetes and Coronary Artery Disease as Risk Factors for Dementia

TY - JOUR

T1 - Diabetes and Coronary Artery Disease as Risk Factors for Dementia

AU - Olesen, Kevin K W

AU - Thrane, Pernille G

AU - Gyldenkerne, Christine

AU - Thomsen, Reimar W

AU - Mortensen, Janne K

AU - Kristensen, Steen D

AU - Maeng, Michael

N1 - © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

PY - 2025/4/1

Y1 - 2025/4/1

N2 - Aims Diabetes is associated with an increased risk of dementia, but it is still debated to which degree this risk depends on the presence of atherosclerotic cardiovascular disease (CVD). In this study, we hypothesize that patients with diabetes and coexisting coronary artery disease (CAD), as a marker of systemic atherosclerotic CVD, have a substantially higher risk of developing dementia. Methods Patients ≥65 years, who underwent coronary angiography, were stratified by diabetes and CAD. Outcomes were all-cause and results dementia, Alzheimer’s dementia, and vascular dementia. We estimated adjusted hazard ratios (aHRs) using patients with neither diabetes nor CAD as a reference. A total of 103 859 patients were included. Of these, 23 189 (22%) had neither diabetes nor CAD, 3876 (4%) had diabetes, 61 020 (59%) had CAD, and 15 774 (15%) had diabetes and CAD. During a median follow-up of 6.3 years, 5592 (5.5%) patients were diagnosed with all-cause dementia. Patients with diabetes and CAD had the highest HR of all-cause dementia [aHR 1.37, 95% confidence interval (CI) 1.24–1.51], including Alzheimer’s dementia (aHR 1.41, 95% CI 1.23–1.62) and vascular dementia (aHR 2.03, 95% CI 1.69–2.45). Patients with diabetes alone (aHR 1.14, 95% CI 0.97–1.33) or CAD alone (aHR 1.11, 95% CI 1.03–1.20) had a modestly increased rate of all-cause dementia. Conclusion The combination of diabetes and CAD is associated with an increased rate of dementia, in particular vascular dementia, suggesting that the diabetes-related risk of dementia is partly mediated through concomitant atherosclerotic CVD. This underscores the importance of atherosclerotic CVD prevention in diabetic patients to reduce cognitive decline.

AB - Aims Diabetes is associated with an increased risk of dementia, but it is still debated to which degree this risk depends on the presence of atherosclerotic cardiovascular disease (CVD). In this study, we hypothesize that patients with diabetes and coexisting coronary artery disease (CAD), as a marker of systemic atherosclerotic CVD, have a substantially higher risk of developing dementia. Methods Patients ≥65 years, who underwent coronary angiography, were stratified by diabetes and CAD. Outcomes were all-cause and results dementia, Alzheimer’s dementia, and vascular dementia. We estimated adjusted hazard ratios (aHRs) using patients with neither diabetes nor CAD as a reference. A total of 103 859 patients were included. Of these, 23 189 (22%) had neither diabetes nor CAD, 3876 (4%) had diabetes, 61 020 (59%) had CAD, and 15 774 (15%) had diabetes and CAD. During a median follow-up of 6.3 years, 5592 (5.5%) patients were diagnosed with all-cause dementia. Patients with diabetes and CAD had the highest HR of all-cause dementia [aHR 1.37, 95% confidence interval (CI) 1.24–1.51], including Alzheimer’s dementia (aHR 1.41, 95% CI 1.23–1.62) and vascular dementia (aHR 2.03, 95% CI 1.69–2.45). Patients with diabetes alone (aHR 1.14, 95% CI 0.97–1.33) or CAD alone (aHR 1.11, 95% CI 1.03–1.20) had a modestly increased rate of all-cause dementia. Conclusion The combination of diabetes and CAD is associated with an increased rate of dementia, in particular vascular dementia, suggesting that the diabetes-related risk of dementia is partly mediated through concomitant atherosclerotic CVD. This underscores the importance of atherosclerotic CVD prevention in diabetic patients to reduce cognitive decline.

KW - Coronary artery disease

KW - Dementia

KW - Diabetes

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=105004278487&partnerID=8YFLogxK

U2 - 10.1093/eurjpc/zwae153

DO - 10.1093/eurjpc/zwae153

M3 - Journal article

C2 - 38680097

SN - 2047-4873

VL - 32

SP - 477

EP - 484

JO - European Journal of Preventive Cardiology

JF - European Journal of Preventive Cardiology

IS - 6

ER -