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Dementia in adult type 2 diabetes patients – An analysis from the multicenter German/Austrian diabetes patient follow-up registry DPV

N. Prinz, L. Wang, J. Stingl, M.D. Denkinger, P. Fasching, P.M. Jehle, S. Merger, S. Mühldorfer, A. Schuler, A. Zeyfang, M. Sharma, R.W. Holl (Ulm, Germany)

Meeting: 2016 International Congress

Abstract Number: 440

Keywords: Dementia

Session Information

Date: Monday, June 20, 2016

Session Title: Epidemiology

Session Time: 12:30pm-2:00pm

Location: Exhibit Hall located in Hall B, Level 2

Objective: To study the presence of dementia in older people with Type 2 diabetes mellitus (T2DM) and to compare demographics with non-demented T2DM patients.

Background: T2DM and cognitive decline are two major public health concerns in older people, with significant association. In the past, dementia prevalence has risen and the most common type in the general population is Alzheimer’s disease (AD). To study dementia in a high-risk population of T2DM patients, we used the standardized, well-established diabetes follow-up registry, DPV (www.d-p-v.eu).

Methods: Currently, 444 specialized diabetes clinics contribute demographic and clinical data on 424,085 diabetes patients to DPV. For this study, 282,914 T2DM patients aged ≥40 years were included. Besides diabetes data, comorbid diagnoses such as dementia are additionally documented in the registry. ICD-10-codes, DSM-IV, and DSM-5 codes, specific search terms for a dementia diagnosis and/or drugs specific for dementia therapy were used to select patients with clinically recognized dementia. A detailed definition is given in ref. [1]. Descriptive statistics with SAS 9.4. Wilcoxon-test was used for continuous variables and χ2-test for binary data. Bonferroni-Holm method was applied for multiple comparisons. Significance was set at a two-sided p<0.05.

Results: 9,117 T2DM patients had comorbid dementia. Table 1 summarizes demographics of patients, stratified by type of dementia. The majority of demented patients had vascular dementia (VD), followed by AD. Patients with dementia were on average older and had a lower BMI. Compared to non-demented patients, the proportion of females was significantly higher in patients with AD, VD, or mixed forms, but significantly lower in patients with other specific types of dementia (e.g. Lewy body dementia, frontotemporal dementia, Parkinson’s dementia) or dementia not otherwise specified. Except for mixed dementia, the use of insulin was significantly more common in demented T2DM patients.

Conclusions: In T2DM, dementia is a growing concern with vascular dementia as the most common type. Although metabolic control seems to be comparable, it might have clinical implications on patient’s nutritional status and diabetes therapy.

Table 1. Patient demographics depending on dementia type
  T2DM
  All no dementia with AD with VD with AD/VD with other specific dementia with dementia not otherwise specified
N 282,914 273,797 975 7,363 88 195 496
Females, % 47.9 47.6 60.5 57.1 54.5 35.9 41.9
Age, years 70.4 [61.2; 77.7] 70.0 [60.9; 77.3] 80.0 [75.2; 85.3] 79.8 [74.0; 85.1] 81.6 [75.9; 86.4] 73.2 [66.8; 79.8] 81.5 [76.2; 86.1]
Diabetes duration, years 8.4 [3.0; 14.8] 8.3 [2.9; 14.8] 10.0 [5.6; 14.7] 10.1 [5.2; 14.9] 9.6 [4.8; 15.2] 8.1 [4.4; 13.4] 9.0 [4.5; 13.4]
BMI, kg/m² 29.7 [26.2; 34.0] (n=247,831) 29.7 [26.2; 34.0] (n=241,057) 27.3 [24.5; 30.8] (n=729) 27.5 [24.5; 31.1] (n=5,508) 27.0 [25.1; 32.1] (n=62) 27.7 [24.9; 31.4] (n=144) 25.9 [23.4; 28.7] (n=331)
Insulin use, % 50.7 50.4 60.4 58.9 51.1 58.5 58.1
Insulin dosage, IU/kg*d 0.5 [0.3; 0.8] (n=134,634) 0.5 [0.3; 0.8] (n=130,216) 0.5 [0.3; 0.8] (n=488) 0.5 [0.3; 0.7] (n=4,334) 0.5 [0.3; 0.7] (n=38) 0.5 [0.4; 0.8] (n=92) 0.5 [0.3; 0.7] (n=220)
HbA1c, mmol/mol 54 [45; 68] (n=251,980) 54 [45; 68] (n=243,952) 53 [44; 67] (n=876) 54 [45; 67] (n=6,480) 51 [44; 62] (n=80) 53 [42; 71] (n=168) 56 [45; 73] (n=424)
P<0.05 for the comparison with no dementia is marked by bold-typed figures.” [1] Prinz N, et al. High rate of hypoglycemia in 6,770 type 2 diabetes patients with comorbid dementia. Diabetes Res Clin Pract (2015).

To cite this abstract in AMA style:

N. Prinz, L. Wang, J. Stingl, M.D. Denkinger, P. Fasching, P.M. Jehle, S. Merger, S. Mühldorfer, A. Schuler, A. Zeyfang, M. Sharma, R.W. Holl. Dementia in adult type 2 diabetes patients – An analysis from the multicenter German/Austrian diabetes patient follow-up registry DPV [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/dementia-in-adult-type-2-diabetes-patients-an-analysis-from-the-multicenter-germanaustrian-diabetes-patient-follow-up-registry-dpv/. Accessed May 15, 2025.
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