OBJECTIVE: We aimed to investigate the differences in clinical characteristics and pharmacological treatment associated with the presence of diabetes in a large cohort of patients with dementia. RESEARCH DESIGN AND METHODS: A cross-sectional registry-based study was conducted using data from the Swedish Dementia Registry (SveDem). Data on dementia diagnosis, dementia type, and demographic determinants were extracted from SveDem. Data from the Swedish Patient Register and Prescribed Drug Register were combined for the diagnosis of diabetes. Data on antidiabetic, dementia, cardiovascular, and psychotropic medications were extracted from the Swedish Prescribed Drug Register. Logistic regression was used to determine whether the variables were associated with diabetes after adjustment for confounders. In total, 29,630 patients were included in the study, and 4,881 (16.5%) of them received a diagnosis of diabetes. RESULTS: In the fully adjusted model, diabetes was associated with lower age at dementia diagnosis (odds ratio [OR] 0.97 [99% CI 0.97-0.98]), male sex (1.41 [1.27-1.55]), vascular dementia (1.17 [1.01-1.36]), and mixed dementia (1.21 [1.06-1.39]). Dementia with Lewy bodies (0.64 [0.44-0.94]), Parkinson disease dementia (0.46 [0.28-0.75]), and treatment with antidepressants (0.85 [0.77-0.95]) were less common among patients with diabetes. Patients with diabetes who had Alzheimer disease obtained significantly less treatment with cholinesterase inhibitors (0.78 [0.63-0.95]) and memantine (0.68 [0.54-0.85]). CONCLUSIONS: Patients with diabetes were younger at dementia diagnosis and obtained less dementia medication for Alzheimer disease, suggesting less optimal dementia treatment. Future research should evaluate survival and differences in metabolic profile in patients with diabetes and different dementia disorders.

Aging Research Center Stockholm University Stockholm Sweden and Department of Neurobiology Care Sciences and Society Karolinska Institutet Huddinge Sweden

Center for Alzheimer Research Division of Clinical Geriatrics Department of Neurobiology Care Sciences and Society Karolinska Institute Huddinge Sweden

Center for Alzheimer Research Division of Neurogeriatrics Department of Neurobiology Care Sciences and Society Karolinska Institutet Huddinge Sweden

Department of Geriatric Medicine Karolinska University Hospital Stockholm Sweden

Department of Neurology and Neurosurgery McGill University Montreal Quebec Canada

National Institute of Mental Health Klecany Czech Republic

Nat Rev Endocrinol. 2017 Sep 12;13(10):570-571. doi: 10.1038/nrendo.2017.111. PubMed

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