title: Glucose tolerance status and risk of dementia in the community: the Hisayama study.
abstract: OBJECTIVE
  We investigated the association between glucose tolerance status defined by a 75-g oral glucose tolerance test (OGTT) and the development of dementia.
  
  
  METHODS
  A total of 1,017 community-dwelling dementia-free subjects aged ≥60 years who underwent the OGTT were followed up for 15 years. Outcome measure was clinically diagnosed dementia.
  
  
  RESULTS
  The age- and sex-adjusted incidence of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD) were significantly higher in subjects with diabetes than in those with normal glucose tolerance. These associations remained robust even after adjustment for confounding factors for all-cause dementia and AD, but not for VaD (all-cause dementia: adjusted hazard ratio [HR] = 1.74, 95% confidence interval [CI] = 1.19 to 2.53, p = 0.004; AD: adjusted HR = 2.05, 95% CI = 1.18 to 3.57, p = 0.01; VaD: adjusted HR = 1.82, 95% CI = 0.89 to 3.71, p = 0.09). Moreover, the risks of developing all-cause dementia, AD, and VaD significantly increased with elevated 2-hour postload glucose (PG) levels even after adjustment for covariates, but no such associations were observed for fasting plasma glucose (FPG) levels: compared with those with 2-hour PG levels of <6.7 mmol/L, the multivariable-adjusted HRs of all-cause dementia and AD significantly increased in subjects with 2-hour PG levels of 7.8 to 11.0 mmol/L or over, and the risk of VaD was significantly higher in subjects with levels of ≥11.1 mmol/L.
  
  
  CONCLUSIONS
  Our findings suggest that diabetes is a significant risk factor for all-cause dementia, AD, and probably VaD. Moreover, 2-hour PG levels, but not FPG levels, are closely associated with increased risk of all-cause dementia, AD, and VaD.
authors.affiliation: Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. kiyohara@envmed.med.kyushu-u.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Ohara
authors.forename: Y
authors.initials: Y
authors.lastname: Doi
authors.forename: T
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Y
authors.initials: Y
authors.lastname: Hirakawa
authors.forename: J
authors.initials: J
authors.lastname: Hata
authors.forename: T
authors.initials: T
authors.lastname: Iwaki
authors.forename: S
authors.initials: S
authors.lastname: Kanba
authors.forename: Y
authors.initials: Y
authors.lastname: Kiyohara
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003704:Dementia / Q000097:blood* / Q000453:epidemiology*; D048909:Diabetes Complications / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test / Q000379:methods; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors
chemical_list: D001786:Blood Glucose