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Impact of diabetes mellitus and chronic liver disease on the incidence of dementia and all-cause mortality among patients with dementia.

Abstract This study investigated the effects of the presence of type 2 diabetes mellitus (T2D) and/or chronic liver disease (CLD) on the incidence and prognosis of dementia during a 10-year period in Korea using a nationwide population-based dataset from the Korea National Health Insurance Service.To assess the impact of T2D and CLD on the incidence of dementia, we included subjects aged ≥60 years without dementia, T2D, and CLD from 2003 to 2005. We created another cohort for evaluating the all-cause mortality in subjects with dementia between 2003 and 2005. The participants were categorized into 4 groups: control (neither CLD nor T2D), CLD-only, T2D-only, and T2D-and-CLD groups, and they were followed up until 2013.The incidence of dementia was higher in the T2D-only group than in the control and CLD-only groups (2.78 vs. 2.04 and 2.00 per 1000 person-years). After adjustment for age, gender, and comorbid conditions, both T2D and CLD increased the risk of any type of dementia; however, the impact of CLD alone was much lower [hazard ratio (HR) 1.07, 95% confidence interval (CI): 1.06-1.08] than that of T2D alone (HR 1.27, 95% CI: 1.27-1.28). The risk of dementia did not significantly change in patients with the co-occurrence of T2D and CLD compared to those with T2D alone. The all-cause mortality rate was the lowest in the control group (2.59 per 1000 person-years) and the highest in the T2D-and-CLD group (3.77 per 1000 person-years). Presence of T2D or CLD alone was associated with higher mortality (HR 1.46 and HR 1.21, respectively) compared with in the absence of both the diseases. Furthermore, the presence of both the diseases further significantly increased the mortality rate compared to the presence of each disease alone (HR 1.67, 95% CI: 1.65-1.69).In conclusion, this study found that the incidence of dementia was much higher in patients with T2D. CLD was associated with a modest increase in risk of dementia; however, there was no additive effect with T2D. In the population with dementia, however, the presence of CLD was associated with high mortality in patients with or without T2D.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29381970
OWN - NLM
STAT- MEDLINE
DCOM- 20180208
LR  - 20180208
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 47
DP  - 2017 Nov
TI  - Impact of diabetes mellitus and chronic liver disease on the incidence of
      dementia and all-cause mortality among patients with dementia.
PG  - e8753
LID - 10.1097/MD.0000000000008753 [doi]
AB  - This study investigated the effects of the presence of type 2 diabetes mellitus
      (T2D) and/or chronic liver disease (CLD) on the incidence and prognosis of
      dementia during a 10-year period in Korea using a nationwide population-based
      dataset from the Korea National Health Insurance Service.To assess the impact of 
      T2D and CLD on the incidence of dementia, we included subjects aged >/=60 years
      without dementia, T2D, and CLD from 2003 to 2005. We created another cohort for
      evaluating the all-cause mortality in subjects with dementia between 2003 and
      2005. The participants were categorized into 4 groups: control (neither CLD nor
      T2D), CLD-only, T2D-only, and T2D-and-CLD groups, and they were followed up until
      2013.The incidence of dementia was higher in the T2D-only group than in the
      control and CLD-only groups (2.78 vs. 2.04 and 2.00 per 1000 person-years). After
      adjustment for age, gender, and comorbid conditions, both T2D and CLD increased
      the risk of any type of dementia; however, the impact of CLD alone was much lower
      [hazard ratio (HR) 1.07, 95% confidence interval (CI): 1.06-1.08] than that of
      T2D alone (HR 1.27, 95% CI: 1.27-1.28). The risk of dementia did not
      significantly change in patients with the co-occurrence of T2D and CLD compared
      to those with T2D alone. The all-cause mortality rate was the lowest in the
      control group (2.59 per 1000 person-years) and the highest in the T2D-and-CLD
      group (3.77 per 1000 person-years). Presence of T2D or CLD alone was associated
      with higher mortality (HR 1.46 and HR 1.21, respectively) compared with in the
      absence of both the diseases. Furthermore, the presence of both the diseases
      further significantly increased the mortality rate compared to the presence of
      each disease alone (HR 1.67, 95% CI: 1.65-1.69).In conclusion, this study found
      that the incidence of dementia was much higher in patients with T2D. CLD was
      associated with a modest increase in risk of dementia; however, there was no
      additive effect with T2D. In the population with dementia, however, the presence 
      of CLD was associated with high mortality in patients with or without T2D.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Kim, Hyun Min
AU  - Kim HM
AD  - Department of Internal Medicine, Chung-Ang University College of Medicine.
FAU - Lee, Yong-Ho
AU  - Lee YH
AD  - Department of Internal Medicine, Yonsei University College of Medicine.
FAU - Han, Kyungdo
AU  - Han K
AD  - Department of Biostatistics, Catholic University of Korea, Seoul, Korea.
FAU - Lee, Byung-Wan
AU  - Lee BW
AD  - Department of Internal Medicine, Yonsei University College of Medicine.
FAU - Kang, Eun Seok
AU  - Kang ES
AD  - Department of Internal Medicine, Yonsei University College of Medicine.
FAU - Kim, Jaetaek
AU  - Kim J
AD  - Department of Internal Medicine, Chung-Ang University College of Medicine.
FAU - Cha, Bong-Soo
AU  - Cha BS
AD  - Department of Internal Medicine, Yonsei University College of Medicine.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cause of Death
MH  - Cohort Studies
MH  - Dementia/epidemiology/etiology/*mortality
MH  - Diabetes Mellitus, Type 2/*complications
MH  - End Stage Liver Disease/*complications
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Republic of Korea/epidemiology
MH  - Risk Factors
PMC - PMC5708969
EDAT- 2018/02/01 06:00
MHDA- 2018/02/09 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/09 06:00 [medline]
AID - 10.1097/MD.0000000000008753 [doi]
AID - 00005792-201711270-00061 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Nov;96(47):e8753. doi: 10.1097/MD.0000000000008753.