Diabetes mellitus in midlife and the risk of dementia three decades later.
OBJECTIVE
To examine the association between diabetes in midlife (1963-1968) and dementia more than three decades later (1999-2001).


METHODS
The authors characterized dementia using standard methods for 1,892 participants among 2,606 survivors of 10,059 participants in the Israeli Ischemic Heart Disease study, a longitudinal investigation of the incidence of and risk factors for cardiovascular disease among Jewish male civil servants in Israel. Face to face interviews were conducted with the 652 subjects identified as possibly demented by the Modified Telephone Interview for Cognitive Status. Logistic regression analysis was performed to assess the association of diabetes with dementia controlling for sociodemographic and cardiovascular variables compared to those with no cognitive impairment.


RESULTS
Of 1,892 assessed subjects (mean age 82 at assessment), 309 (16.3%) had dementia. Diabetic subjects had significantly more dementia than non-diabetic subjects (chi2 = 7.54, df = 1, p = 0.006, OR 2.83 [95% CI = 1.40 to 5.71]). Those who survived to the time of this study were younger and healthier than those who died.


CONCLUSIONS
Evidence for diabetes as a risk factor for dementia was found, similar to other epidemiologic studies. In contrast to the earlier studies, however, the authors linked diabetes in midlife to dementia more than three decades later in the very old survivors of a large male cohort.
Schnaider Beeri
M
M
Department of Psychiatry, Mount Sinai School of Medicine, One Gustave Levy Place, Box 1230, New York, NY 10029, USA. michal.beeri@mssm.edu
Goldbourt
U
U
Silverman
J M
JM
Noy
S
S
Schmeidler
J
J
Ravona-Springer
R
R
Sverdlick
A
A
Davidson
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D003704:Dementia / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007557:Israel; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors
D008076:Cholesterol, HDL