Diabetes status, duration, and risk of dementia among ischemic stroke patients

 You, your mentors and senior researchers don't read research, do you?

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018

5. Brain Bleeds Double Dementia Risk February 2025

The latest here:

Diabetes status, duration, and risk of dementia among ischemic stroke patients

• Jonguk Kim,
• Kyung-Do Han,
• Jeong-Yoon Lee,
• Ye Seul Yang,
• Dae Young Cheon,
• Jae-Jun Lee &
• Minwoo Lee 

Alzheimer's Research & Therapy volume 17, Article number: 58 (2025) Cite this article

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Abstract

Background

The influence of duration of type 2 diabetes mellitus (T2DM) on the likelihood of developing new-onset dementia in post-stroke population is not well understood.(It is if you read research!) Therefore, we aimed to clarify the relationship between the duration of T2DM and the risk of developing dementia in the post-stroke population.

Methods

Leveraging the Korean National Health Insurance Database, this study included 118,790 individuals with a history of stroke but no previous dementia diagnosis. We classified diabetes status into five categories: normoglycemia, impaired fasting glucose (IFG), newly diagnosed T2DM, and established T2DM with durations of less than 5 years and 5 years or more. The primary endpoint was the incidence of all-cause dementia.

Results

Among 118,790 participants (average age 64.26 ± 9.95 years, 48% male), 16.7% developed dementia during an average follow-up of 7.3 ± 2.3 years. Participants with a history of T2DM for less than five years at cohort entry had a 26.7% higher risk of developing all-cause dementia compared to those with normoglycemia. Those with T2DM for five years or longer had a 46.7% increased risk, with an adjusted hazard ratio (aHR) of 1.466 (95% confidence interval [CI], 1.408–1.527). Specifically, the risk of developing Alzheimer's disease (AD) and vascular dementia (VaD) rose by 43.4% and 51.4%, respectively, for individuals with T2DM lasting more than five years (aHR 1.434, 95% CI 1.366–1.505; aHR 1.514, 95% CI 1.365–1.679, respectively).

Conclusions

Our findings demonstrated a significant association between an extended duration of T2DM and an increased risk of developing all-cause dementia, including AD and VaD in post-stroke population. These results emphasize proactive dementia prevention approaches in stroke survivors, particularly those with longstanding T2DM.

Introduction

The incidence of cognitive impairments following a stroke, notably Post-Stroke Cognitive Impairment and Post-Stroke Dementia (PSD), significantly contributes to the disability burden observed in post-stroke survivors [1,2,3,4]. This issue is increasingly prevalent in developed nations, where an aging population and healthcare advancements have led to reduced mortality but an elevated incidence of PSD [3]. Notably, PSD can develop independently of functional impairments poststroke, leading to considerable decreases in independence for daily activities [5]. Such conditions not only increase healthcare costs but also profoundly affect the quality of life for patients and their caregivers.

Given the clinical significance of PSD, identifying and modifying its risk factors is crucial, especially since direct preventive treatments are scarce. Therefore, the focus shifts to the understanding and addressing of risk factors [4, 6]. Known risk factors for PSD include age, educational level, stroke severity, post-stroke functional status, stroke lesion location, visible neuroimaging markers, vascular risks, and lifestyle factors [1, 3, 7,8,9]. Among these, type 2 diabetes mellitus (T2DM) has emerged as a key risk factor, increasing the risk of both stroke recurrence and PSD [1, 10, 11]. However, the nuanced relationship between prediabetes and PSD, as well as the role of T2DM duration in PSD risk, remains inadequately explored [10, 11]. As a vascular risk factor, T2DM may play a greater role in the development of vascular dementia, however, the differential impact of duration of T2DM on each type of dementia has not been fully understood [12].

Therefore, our study aimed to investigate the association between the duration of T2DM and the risk of developing dementia in individuals who have experienced acute stroke. To achieve this goal, we utilized data from the Korean National Health Insurance Service (K-NHIS) database, which encompasses the vast majority of the Korean population.