Diabetes mellitus and the Risk of Dementia, Alzheimer’s Disease and Vascular Cognitive Impairment in the Canadian Study of Health and Aging
Abstract
Background: Conflicting results have been reported about the status of diabetes mellitus as a risk for Alzheimer’s disease. We investigated the relationship between diabetes and incident dementia (including Alzheimer’s disease and vascular cognitive impairment) in a 5-year longitudinal study. Methods: Secondary analysis of the Canadian Study of Health and Aging, a representative cohort study of dementia in older Canadians. Results: 5,574 subjects without cognitive impairment at baseline participated in 5-year follow-up. Diabetes mellitus at baseline was associated with incident vascular cognitive impairment (RR: 1.62; 95% CI: 1.12–2.33) and its subtypes, vascular dementia (RR: 2.03; 95% CI: 1.15–3.57), and vascular cognitive impairment not dementia (RR: 1.68; 95% CI: 1.01–2.78). Diabetes was not associated with mixed Alzheimer’s/vascular dementia (RR: 0.87; 95% CI: 0.34–2.21), incident Alzheimer’s disease (RR: 1.30; 95% CI: 0.83–2.03) or all dementias (RR: 1.26; 95% CI: 0.90–1.76). Conclusions: Despite increased recognition of the role of vascular factors in Alzheimer’s disease, we did not find an association between diabetes and incident Alzheimer’s disease, even though diabetes was associated with incident vascular cognitive impairment.
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The incidence of all-cause dementia and vascular dementia among adults with diabetes in prospective cohort studies was estimated to be 14.2 to 16.8 per 1000 patient-years and 1.8 to 3.2 per 1000 patient-years, respectively, more than double the rate reported in this study.
“The incidence of all-cause dementia and vascular dementia among adults with diabetes in prospective cohort studies was estimated to be 14.2 to 16.8 per 1000 patient-years and 1.8 to 3.2 per 1000 patient-years, respectively, more than double the rate reported in this study.60,61”
From Cardioprotective Glucose-Lowering Agents and Dementia Risk: A Systematic Review and Meta-Analysis (2025) · cites this paper as [61]
Studies reporting the development of future dementia reported that people with diabetes had a higher risk of all-cause dementia than people without diabetes.
“Studies reporting the development of future dementia of these reported that people with diabetes had a higher risk of all-cause dementia than people without diabetes [56, 58, 64, 65, 67].”
From Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies (2005) · cites this paper as [64]
Prospective epidemiological studies show a relationship between cognitive decline and clinical markers associated with hyperglycaemia (e.g., use of glucose-lowering medication, diabetes duration, diabetes complications).
“Finally, prospective epidemiological studies also show a relationship between cognitive decline and clinical markers associated with hyperglycaemia, e.g. use of glucose-lowering medication, diabetes duration and diabetes complications [46, 48, 49, 54, 56, 64].”
From Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies (2005) · cites this paper as [64]
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- Authors
- MacKnight, C., Rockwood, K., Awalt, E., & McDowell, I.
- Affiliations
- Dalhousie University (CA)
- University of Ottawa (CA)
- Venue
- Dementia and Geriatric Cognitive Disorders
- Publisher
- S. Karger AG
- Published
- 2002
- Volume
- 14
- Issue
- 2
- Pages
- 77-83
- ISSN
- 1420-8008 (ISSN-L)
- 1421-9824
- OpenAlex
- W2050640530
- Cited by
- 313
- References
- 40
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 4 · 2023: 3 · 2022: 8 · 2021: 7 · 2020: 7 · 2019: 19 · 2018: 12 · 2017: 13 · 2016: 15 · 2015: 12 · 2014: 21 · 2013: 20 · 2012: 12
- FWCI
- 5.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Dementia and Geriatric Cognitive Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- diabetes mellitus, Alzheimer's disease, dementia, vascular cognitive impairment, vascular dementia, incident dementia risk, older adults, Canadian Study of Health and Aging
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Dementia, Diabetes Mellitus, Female, Humans, Male, Risk Factors, Dementia, Vascular, Cohort Studies
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