Diabetes Res Clin Pract. 2025 Sep 18:112909. doi: 10.1016/j.diabres.2025.112909. Online ahead of print.
ABSTRACT
AIMS: To evaluate associations of glycemic status with incident early-onset dementia (EOD) and late-onset dementia (LOD), dementia-free life expectancy, brain MRI structure measures, as well as the mediation pathway of depressive episode METHODS: A population-based cohort study based on UK Biobank, enrolling a total of 286 743 (mean [SD] age, 51.5 [5.9] years) and 330 103 participants (mean [SD] age, 60.7 [5.0] years) for analyzing EOD and LOD, respectively. Incident EOD was defined as dementia diagnosis before age 65, and LOD defined as dementia after age 65.
RESULTS: Diabetes participants with optimal glycemic control respectively had a 47 % lower EOD incidence and a 17 % lower LOD incidence, up to 3.2 years longer dementia-free lifespan at age 50, and better dementia-related brain structure measures, compared to counterparts with worse glycemic status. Incident depressive episode mediated 18.8 % (P = 0.014) and 7.8 % (P < 0.001) of associations between glycemic status with EOD and LOD, respectively.
CONCLUSIONS: Better glycemic status was associated with reduced EOD and LOD risks, prolonged dementia-free lifespan, and brain MRI measures, partiality mediated by depressive episode. These findings support the potential significance of reaching ideal glycemic status to prevent dementia onset and prolong dementia-free longevity at the early pre-symptomatic stage in young diabetes.
PMID:40975178 | DOI:10.1016/j.diabres.2025.112909
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