TY - CHAP
T1 - Diabetic Retinopathy Predicts Risk of Alzheimer's Disease
T2 - A Danish Registry-Based Nationwide Cohort Study
AU - Pedersen, Frederik Nørregaard
AU - Stokholm, Lonny
AU - Pouwer, Frans
AU - Hass Rubin, Katrine
AU - Peto, Tunde
AU - Frydkjær-Olsen, Ulrik
AU - Thykjær, Anne Suhr
AU - Andersen, Nis
AU - Andresen, Jens
AU - Bek, Toke
AU - La Cour, Morten
AU - Heegaard, Steffen
AU - Højlund, Kurt
AU - Kawasaki, Ryo
AU - Hajari, Javad Nouri
AU - Ohm Kyvik, Kirsten
AU - Laugesen, Caroline Schmidt
AU - Schielke, Katja Christina
AU - Simó, Rafael
AU - Grauslund, Jakob
PY - 2024
Y1 - 2024
N2 - Background: Retinal neurodegeneration is evident in early diabetic retinopathy (DR) which may be associated with other neurodegenerative diseases like Alzheimer's disease (AD). Objective: To investigate diabetes and DR as a risk marker of present and incident AD. Methods: A register-based cohort study was performed. We included 134,327 persons with diabetes above 60 years of age, who had attended DR screening, and 651,936 age- and sex-matched persons without diabetes. Results: At baseline, the prevalence of AD was 0.7% and 1.3% among persons with and without diabetes, respectively. In a multivariable regression model, persons with diabetes were less likely to have AD at baseline (adjusted OR 0.63, 95% CI 0.590.68). During follow-up, incident AD was registered for 1473 (0.35%) and 6,899 (0.34%) persons with and without diabetes, respectively. Compared to persons without diabetes, persons with diabetes and no DR had a lower risk to develop AD (adjusted HR 0.87, 95% CI 0.810.93), while persons with diabetes and DR had higher risk of AD (adjusted HR 1.24, 95% CI 1.081.43). When persons with diabetes and no DR were used as references, a higher risk of incident AD was observed in persons with DR (adjusted HR 1.34, 95% CI 1.181.53). Conclusion: Individuals with diabetes without DR were less likely to develop AD compared to persons without diabetes. However, individuals with DR had a 34% higher risk of incident AD, which raise the question whether screening for cognitive impairment should be done among individuals with DR.
AB - Background: Retinal neurodegeneration is evident in early diabetic retinopathy (DR) which may be associated with other neurodegenerative diseases like Alzheimer's disease (AD). Objective: To investigate diabetes and DR as a risk marker of present and incident AD. Methods: A register-based cohort study was performed. We included 134,327 persons with diabetes above 60 years of age, who had attended DR screening, and 651,936 age- and sex-matched persons without diabetes. Results: At baseline, the prevalence of AD was 0.7% and 1.3% among persons with and without diabetes, respectively. In a multivariable regression model, persons with diabetes were less likely to have AD at baseline (adjusted OR 0.63, 95% CI 0.590.68). During follow-up, incident AD was registered for 1473 (0.35%) and 6,899 (0.34%) persons with and without diabetes, respectively. Compared to persons without diabetes, persons with diabetes and no DR had a lower risk to develop AD (adjusted HR 0.87, 95% CI 0.810.93), while persons with diabetes and DR had higher risk of AD (adjusted HR 1.24, 95% CI 1.081.43). When persons with diabetes and no DR were used as references, a higher risk of incident AD was observed in persons with DR (adjusted HR 1.34, 95% CI 1.181.53). Conclusion: Individuals with diabetes without DR were less likely to develop AD compared to persons without diabetes. However, individuals with DR had a 34% higher risk of incident AD, which raise the question whether screening for cognitive impairment should be done among individuals with DR.
KW - Alzheimer's disease
KW - cognitive impairment
KW - diabetes mellitus
KW - diabetic retinopathy
U2 - 10.3233/AIAD230037
DO - 10.3233/AIAD230037
M3 - Book chapter
AN - SCOPUS:85185293447
SN - 978-1-64368-492-5
T3 - Advances in Alzheimer's Disease
SP - 395
EP - 406
BT - Handbook of Prevention and Alzheimer’s Disease
A2 - Raji, Cyrus A.
A2 - Leng, Yue
A2 - Ashford, J. Wesson
A2 - Khalsa, Dharma Singh
PB - IOS Press
ER -