Healthy lifestyle and all‐cause and cause‐specific dementia in individuals with type 2 diabetes and the roles of diabetes duration and insulin use in UK Biobank cohort

Author:

Zhou Chunmiao1,Dong Caiyun1,Wang Qi23,Fu Chunying1,Xie Ziwei1,Hao Wenting23,Sun Huizi1,Zhu Dongshan1ORCID

Affiliation:

1. Department of Epidemiology School of Public Halth, Cheeloo College of Medicine, Shandong University Jinan China

2. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University Jinan China

3. NHC Key Lab of Health Economics and Policy Research (Shandong University) Jinan China

Abstract

AbstractAimsTo examine the effect of a healthy lifestyle score derived from seven lifestyle factors recommended by the diabetes management guidelines on all‐cause and cause‐specific dementia in individuals with type 2 diabetes mellitus (T2DM), and how diabetes duration and insulin use status modify their association.Materials and MethodsThis study analysed data of 459 840 participants from the UK Biobank. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals for the association of an overall healthy lifestyle score with all‐cause and cause‐specific dementia of Alzheimer's disease, vascular dementia and non‐Alzheimer non‐vascular dementia.ResultsUsing diabetes‐free participants who scored 5‐7 as the reference group, in diabetes‐free participants, we observed higher healthy lifestyle score was related to lower risk of all‐cause and cause‐specific dementia. However, in people with T2DM, those scored 2‐3, 4 and 5‐7 all had around the two‐time risk of all‐cause dementia (HR: 2.20‐2.36), while those scored 0‐1 had over a three‐time risk (HR: 3.14, 95% confidence interval 2.34‐4.21). A dose‐response trend was observed with vascular dementia (each 2‐point increase: 0.75, 0.61‐0.93) and no significant association with Alzheimer's disease (0.95, 0.77‐1.16). The reduced risk of all‐cause and cause‐specific dementia with higher lifestyle score was observed in patients with a diabetes duration less than 10 years, or in patients with no insulin use.ConclusionIn people with T2DM, higher healthy lifestyle score was associated with lower risk of all‐cause dementia. Diabetes duration and insulin use moderated the association between healthy lifestyle score and risk of dementia.

Funder

National Natural Science Foundation of China

Publisher

Wiley

Subject

Endocrinology,Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference50 articles.

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