New Method to Predict Dementia Risk for Type 2 Diabetics

Abel

Abel Corona of Watsonville pours piña colada from a pitcher at his home. He is more careful about his diet since he was diagnosed with diabetes. He is a student in a diabetes self-management education class at a local health clinic, Salud Para la Gente, or Health for the People. (Vinnee Tong/KQED)

An international team of researchers says it’s developed a tool that predicts the risk that a senior with type 2 diabetes will develop dementia in the next 10 years.

People with type 2 diabetes are known to be at a high risk of developing dementia – a range of problems that hinder memory, language, and problem solving. In fact, type 2 diabetics are two times more likely to develop dementia later in life than people without the disease.

According to a paper published today in the new journal The Lancet Diabetes & Endocrinology, researchers have created a 20-point “risk score,” which they assign to patients based on their personal history and health issues. With each point on the scale, a person’s risk for developing dementia within 10 years grows. It’s the first risk score to be developed specifically for people with type 2 diabetes.

“[The risk score] puts these patients on the radar of clinicians to know they are at high risk,” said Rachel Whitmer, a scientist with Kaiser Permanente Division of Research in Oakland, Calif. With this score in hand “the clinician could be especially attentive to looking out for memory or cognitive problems.”

Whitmer boasts that the simple risk score can be quickly calculated from a patient’s electronic medical records or at a routine doctor’s appointment.

The researchers developed the score by finding type 2 diabetic seniors who did not have dementia. The team then followed these patients for 10 years.

Nearly 30,000 Californians, 60 years old or older were part of the study. Researchers gleaned information about each patient’s general health, diabetic complications and problems with blood sugar levels using their electronic health records stored in the Kaiser Permanente Northern California Diabetes Registry.

The team discovered eight factors that predicted the risk of developing dementia within the following decade including, a variety of vascular complications, problems with wide fluctuations in blood sugar level, depression, age, and education.

Points are given to patients based how many of these health issues they have, their age, and their level of education. People in the lowest point category had a 5.3 percent risk for developing dementia within 10 years, while the risk for those in the highest category grew to 73.3 percent.

In short, people whose diabetes is less controlled tend to have a higher risk score and may be more likely to develop dementia.

“If we can predict future risk, we then know who to focus on, who to follow more, who to spend [extra] time making sure they are taking care of themselves in terms of their type 2 diabetes,” said Whitmer.

Since dementia predominantly affects the elderly, the older you are the more points you rack up on the risk score.

“If you are elderly and have type 2 diabetes, yes, you are at higher risk, but all the more reason to have appropriate glycemic control,” said Whitmer. While someone’s age is out of their control, patients can work to better manage their diabetes and seek treatment for another risk factor, depression, she added.

By creating a 10-year risk score, the researchers hope to catch high-risk people before they start having cognitive issues.

Scientists don’t know exactly why people with type 2 diabetes are at a greater risk for dementia.

Some types of dementia may manifest due to reduced blood flow to the brain. And diabetes can damage blood vessels that send blood to all parts of the body, including the brain.

To date, there hasn’t been enough data available for scientists to determine if people with type 1 diabetes are also at a heightened risk for dementia.

Whitmer and her colleagues are in the process in developing a risk score for younger people with type 2 diabetes that can predict the risk of dementia for 40 years out.

“I think it’s important for this population to know that this disease can affect their brain and can greatly affect the quality of their life,” Whitmer said.

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