Women with type 2 diabetes appear to have a greater risk for vascular dementia, but not non-vascular dementia, as compared with men and those without the disease, according to a systematic review published in Diabetes Care.
“The present analyses provide further support for the hypothesis that the adverse consequences of diabetes on vascular risk are stronger in women than in men,” Saion Chatterjee, from the Alfred Health in Melbourne, Australia, and colleagues wrote in their study. “Although a sex disparity in the management and treatment of diabetes, most often to the detriment of women, may be involved, accruing evidence suggests that real biological differences between women and men underpin the excess risk of diabetes-related vascular risk in women.”
The researchers identified 2 310 330 patients with diabetes, with a subset of 102 174 patients who had dementia, from 14 studies. They performed random-effects meta-analyses using data from sex-specific relative risks (RRs) and 95% confidence intervals (CI) between diabetes and dementia subtypes, according to the abstract.
“Our findings offer support for a role of diabetes in the etiology of dementia, although the magnitude of the relationship differs according to subtype,” Dr Chatterjee and colleagues wrote.
Specifically, the researchers found an association between diabetes and a 60% increased risk for developing any dementia in both sexes. The pooled RRs were 1.62 (95% CI, 1.45-1.80) for women and 1.58 (95% CI, 1.38-1.81) for men.
For vascular dementia, the diabetes-associated risk was greater for women than men, with RRs of 2.34 (95% CI, 1.86-2.94) vs 1.73 (95% CI, 1.61-1.85), respectively.
However, for non-vascular dementia, the RR was 1.53 (95% CI, 1.35-1.73) for women and 1.49 (95% CI, 1.31-1.69) for men.
“Future prospective studies, with extensive phenotypic and genetic data on risk factors common to both diabetes and subtypes of dementia, are needed to examine whether these relationships are causal,” the researchers wrote.
“Moreover, our finding of a greater diabetes-related risk of vascular dementia in women than in men contributes to the growing evidence base that diabetes confers a proportionally greater vascular hazard in women than in men,” they concluded.
- Chatterjee S, Peters SAE, Woodward M, et al. Type 2 Diabetes as a Risk Factor for Dementia in Women Compared With Men: A Pooled Analysis of 2.3 Million People Comprising More Than 100,000 Cases of Dementia. Diabetes Care. 2015;doi:10.2337/dc15-1588.