open access publication

Chapter, 2024

Diabetic retinopathy predicts risk of Alzheimer's disease: A Danish registry-based nationwide cohort study

Handbook of Prevention and Alzheimer S Disease 9781643684925, 9781643684932, Pages 395-406

Editors:

Publisher: IOS Press

DOI: 10.3233/AIAD230037

Contributors

Pedersen F.N. 0000-0003-3713-9949 (Corresponding author) [1] [2] Stokholm L. 0000-0002-9727-6649 [1] Pouwer F. 0000-0002-8172-9818 [1] [2] Rubin K.H. 0000-0001-5045-536X [1] Peto T. 0000-0001-6265-0381 [1] [3] Frydkjaer-Olsen U. [4] Thykjaer A.S. 0000-0002-2621-4360 [1] [2] Andersen N. 0000-0002-1133-7456 [5] Andresen J. 0000-0002-3936-3429 [5] Bek T. 0000-0002-0409-2534 [6] La Cour M. 0000-0002-7712-9772 [7] [8] Heegaard S. 0000-0001-5906-7670 [7] [8] Hojlund K. 0000-0002-0891-4224 [1] [2] Kawasaki R. 0000-0002-7492-6303 [1] [9] Hajari J.N. 0000-0001-5336-8253 [8] Kyvik K.O. 0000-0003-2981-0245 [1] Laugesen C.S. 0000-0003-4279-8180 [10] Schielke K.C. 0000-0002-4281-9626 [11] Simo R. 0000-0003-0475-3096 [12] Grauslund J. 0000-0001-5019-0736 [1] [2]

Affiliations

  1. [1] University of Southern Denmark
  2. [NORA names: SDU University of Southern Denmark; University; Denmark; Europe, EU; Nordic; OECD];
  3. [2] Odense University Hospital
  4. [NORA names: Region of Southern Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];
  5. [3] School of Medicine
  6. [NORA names: United Kingdom; Europe, Non-EU; OECD];
  7. [4] Vejle Hospital
  8. [NORA names: Region of Southern Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];
  9. [5] Organization of Danish Practicing Ophthalmologists
  10. [NORA names: Other Hospitals; Hospital; Denmark; Europe, EU; Nordic; OECD];

Abstract

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 0.59-0.68). 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 0.81-0.93), while persons with diabetes and DR had higher risk of AD (adjusted HR 1.24, 95% CI 1.08-1.43). 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 1.18-1.53). 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.

Keywords

Alzheimer's disease, Cognitive impairment, Diabetes mellitus, Diabetic retinopathy

Data Provider: Elsevier