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Association of type 2 diabetes mellitus with dementia‐related and non–dementia‐related mortality among postmenopausal women: A secondary competing risks analysis of the women's health initiative
Journal article   Open access   Peer reviewed

Association of type 2 diabetes mellitus with dementia‐related and non–dementia‐related mortality among postmenopausal women: A secondary competing risks analysis of the women's health initiative

Tyler J. Titcomb, Phyllis Richey, Ramon Casanova, Lawrence S. Phillips, Simin Liu, Shama D. Karanth, Nazmus Saquib, Tomas Nuño, JoAnn E. Manson, Aladdin H. Shadyab, …
Alzheimer's & dementia, Vol.20(1), pp.234-242
01/2024
DOI: 10.1002/alz.13416
PMCID: PMC10916943
PMID: 37563765
url
https://doi.org/10.1002/alz.13416View
Published (Version of record) Open Access

Abstract

Abstract INTRODUCTION Alzheimer's disease (AD) and AD‐related dementias (ADRD) are leading causes of death among older adults in the United States. Efforts to understand risk factors for prevention are needed. METHODS Participants ( n  = 146,166) enrolled in the Women's Health Initiative without AD at baseline were included. Diabetes status was ascertained from self‐reported questionnaires and deaths attributed to AD/ADRD from hospital, autopsy, and death records. Competing risk regression models were used to estimate the cause‐specific hazard ratios (HRs) and 95% confidence intervals (CIs) for the prospective association of type 2 diabetes mellitus (T2DM) with AD/ADRD and non‐AD/ADRD mortality. RESULTS There were 29,393 treated T2DM cases and 8628 AD/ADRD deaths during 21.6 (14.0–23.5) median (IQR) years of follow‐up. Fully adjusted HRs (95% CIs) of the association with T2DM were 2.94 (2.76–3.12) for AD/ADRD and 2.65 (2.60–2.71) for the competing risk of non‐AD/ADRD mortality. DISCUSSION T2DM is associated with AD/ADRD and non‐AD/ADRD mortality. Highlights Type 2 diabetes mellitus is more strongly associated with Alzheimer's disease (AD)/AD and related dementias (ADRD) mortality compared to the competing risk of non‐AD/ADRD mortality among postmenopausal women. This relationship was consistent for AD and ADRD, respectively. This association is strongest among participants without obesity or hypertension and with younger age at baseline, higher diet quality, higher physical activity, higher alcohol consumption, and older age at the time of diagnosis of type 2 diabetes mellitus.

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