title: Risk of Alzheimer's disease in relation to diabetes: a population-based cohort study.
abstract: OBJECTIVE
  Detailed information on the age- and sex-specific relationships between diabetes and Alzheimer's disease (AD) is scarce. This study aims to prospectively investigate the age- and sex-specific incidence density and relative hazards of AD in relation to diabetes.
  
  
  METHODS
  A total of 615,529 diabetic patients and 614,871 age- and sex-matched random controls were linked to the claim data from 2000-2008 to identify the first occurrence of a primary or secondary diagnosis of AD. Incidence density was calculated under the Poisson assumption. We also assessed the age- and sex-specific risk of AD in relation to diabetes with the Cox proportional hazards regression model.
  
  
  RESULTS
  Over nearly 9 years of follow-up, a total of 4,615 diabetic subjects developed AD, representing a cumulative incidence rate of 0.75% (n = 3,873; 0.63% in controls). The overall incidence densities of AD for diabetic men and women, respectively, were 0.82 and 1.15 per 1,000 person-years, which were higher than those for control men and women (0.63 and 0.89 per 1,000 person-years, respectively). Diabetic patients had a significantly higher hazard ratio (HR) of AD [1.45, 95% confidence interval (CI) 1.38-1.52]. Diabetic women ≥65 years had a higher HR (1.52, 95% CI 1.42-1.62) than diabetic women <65 years (1.34, 95% CI 1.15-1.56).
  
  
  CONCLUSIONS
  Diabetes may increase the risk of AD in both sexes and in all ages. A higher HR of AD was especially notable in older diabetic women.
authors.affiliation: Department of Neurology, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC.
authors.forename: Kai-Chen
authors.initials: KC
authors.lastname: Wang
authors.forename: Lin-Chung
authors.initials: LC
authors.lastname: Woung
authors.forename: Ming-Tsu
authors.initials: MT
authors.lastname: Tsai
authors.forename: Chih-Ching
authors.initials: CC
authors.lastname: Liu
authors.forename: Ying-Hwa
authors.initials: YH
authors.lastname: Su
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Li
mesh_terms: D000367:Age Factors; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology