Sarcopenia and diabetes-induced dementia risk

Mingyang Sun; Zhongyuan Lu; Wan-Ming Chen; Szu-Yuan Wu; Jiaqiang Zhang

doi:10.1093/braincomms/fcad347

Sarcopenia and diabetes-induced dementia risk

Brain Commun. 2023 Dec 20;6(1):fcad347. doi: 10.1093/braincomms/fcad347. eCollection 2024.

Authors

Mingyang Sun^{1

2}, Zhongyuan Lu^{1

2}, Wan-Ming Chen^{3

4}, Szu-Yuan Wu^{3

4

5

6

7

8

9

10

11}, Jiaqiang Zhang^{1

2}

Affiliations

¹ Department of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan 450052China.
² Academy of Medical Sciences of Zhengzhou University, Zhengzhou, Henan 450052, China.
³ Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei 242, Taiwan.
⁴ Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei 242, Taiwan.
⁵ Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.
⁶ Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
⁷ Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
⁸ Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.
⁹ Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265, Taiwan.
¹⁰ Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan.
¹¹ Department of Management, College of Management, Fo Guang University, Yilan 262, Taiwan.

Abstract

This study aimed to investigate whether sarcopenia independently increases the risk of diabetes-induced dementia in elderly individuals diagnosed with type 2 diabetes mellitus. The study cohort consisted of a large sample of elderly individuals aged 60 years and above, who were diagnosed with type 2 diabetes mellitus between 2008 and 2018. To minimize potential bias and achieve covariate balance between the sarcopenia and non-sarcopenia groups, we employed propensity score matching. Various statistical analyses, including Cox regression models to assess dementia risk and associations, competing risk analysis to account for mortality and Poisson regression analysis for incidence rates, were used. Before propensity score matching, the study included 406 573 elderly type 2 diabetes mellitus patients, with 20 674 in the sarcopenia group. Following propensity score matching, the analysis included a total of 41 294 individuals, with 20 647 in the sarcopenia group and 20 647 in the non-sarcopenia group. Prior to propensity score matching, elderly type 2 diabetes mellitus patients with sarcopenia exhibited a significantly higher risk of dementia (adjusted hazard ratio: 1.12, 95% confidence interval: 1.07-1.17). After propensity score matching, the risk remained significant (adjusted hazard ratio: 1.14, 95% confidence interval: 1.07-1.21). Incidence rates of dementia were notably higher in the sarcopenia group both before and after propensity score matching, underscoring the importance of sarcopenia as an independent risk factor. Our study highlights sarcopenia as an independent risk factor for diabetes-induced dementia in elderly type 2 diabetes mellitus patients. Advanced age, female gender, lower income levels, rural residency, higher adapted diabetes complication severity index and Charlson Comorbidity Index scores and various comorbidities were associated with increased dementia risk. Notably, the use of statins was linked to a reduced risk of dementia. This research underscores the need to identify and address modifiable risk factors for dementia in elderly type 2 diabetes mellitus patients, offering valuable insights for targeted interventions and healthcare policies.

Keywords: T2DM; diabetes-associated dementia; old-age; risk factors; sarcopenia.