Association of diabetes with stroke and post-stroke dementia: A population-based cohort study

被引:38
作者
Shang, Ying [1 ,2 ]
Fratiglioni, Laura [1 ,2 ,3 ]
Marseglia, Anna [1 ,2 ]
Plym, Anna [4 ]
Welmer, Anna-Karin [1 ,2 ,5 ]
Wang, Hui-Xin [1 ,2 ,6 ]
Wang, Rui [1 ,2 ,7 ,8 ]
Xu, Weili [1 ,2 ,9 ]
机构
[1] Karolinska Inst, Dept Neurobiol Care Sci & Soc, Aging Res Ctr, Stockholm, Sweden
[2] Stockholm Univ, Stockholm, Sweden
[3] Stockholm Gerontol Res Ctr, Stockholm, Sweden
[4] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden
[5] Karolinska Univ Hosp, Funct Area Occupat Therapy & Physiotherapy, Stockholm, Sweden
[6] Stockholm Univ, Stress Res Inst, Stockholm, Sweden
[7] Univ Wisconsin, Sch Med & Publ Hlth, Wisconsin Alzheimers Dis Res Ctr, Madison, WI USA
[8] GIH, Swedish Sch Sport & Hlth Sci, Stockholm, Sweden
[9] Tianjin Med Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Tianjin, Peoples R China
基金
瑞典研究理事会; 中国国家自然科学基金;
关键词
dementia; ischemic stroke; population-based cohort study; post-stroke dementia; prediabetes; type; 2; diabetes; ALZHEIMERS-DISEASE; RISK; MELLITUS; BLOOD; HYPERGLYCEMIA; MORTALITY; STATE;
D O I
10.1002/alz.12101
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Introduction: The impact of prediabetes and diabetes on stroke and the development of dementia after a stroke remain unclear. Methods: A total of 2655 dementia-free participants (including a stroke-free cohort and a prevalent stroke cohort) were followed-up for 12 years. Dementia and post-stroke dementia were determined by clinical examinations and national registry data. Diabetes was ascertained via medical examination, medication use, medical records, or glycated hemoglobin (HbA1c) >= 6.5%. Prediabetes was defined as H bA1c >= 5.7% in diabetes-free participants. Results: In the stroke-free cohort, 236 participants developed ischemic stroke, and 47 developed post-stroke dementia. Diabetes was associated with ischemic stroke (hazard ratio [HR] 1.76, 95% confidence interval [CI] 1.16 to 2.67) and post-stroke dementia (HR 2.56, 95% CI 1.04 to 6.25). In the prevalent stroke cohort, diabetes was also related to dementia risk. Prediabetes was not significantly related to stroke or post-stroke dementia. Discussion: Diabetes, but not prediabetes, is associated with an increased risk of ischemic stroke and post-stroke dementia.
引用
收藏
页码:1003 / 1012
页数:10
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