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Heterogeneity in the effect of type 2 diabetes on dementia incidence in a diverse cohort of Asian American and non-Latino White older adults.
- Source :
- American Journal of Epidemiology; Sep2024, Vol. 193 Issue 9, p1261-1270, 10p
- Publication Year :
- 2024
-
Abstract
- Dementia incidence is lower among Asian Americans than among Whites, despite higher prevalence of type 2 diabetes, a well-known dementia risk factor. Determinants of dementia, including type 2 diabetes, have rarely been studied in Asian Americans. We followed 4846 Chinese, 4129 Filipino, 2784 Japanese, 820 South Asian, and 123 360 non-Latino White members of a California-based integrated health-care delivery system from 2002 to 2020. We estimated dementia incidence rates by race/ethnicity and type 2 diabetes status, and we fitted Cox proportional hazards and Aalen additive hazards models for the effect of type 2 diabetes (assessed 5 years before baseline) on age of dementia diagnosis, controlling for sex/gender, educational attainment, nativity, height, race/ethnicity, and a race/ethnicity × diabetes interaction. Type 2 diabetes was associated with higher dementia incidence in Whites (hazard ratio [HR] = 1.46; 95% CI, 1.40-1.52). Compared with Whites, the estimated effect of diabetes was larger in South Asians (HR = 2.26; 95% CI, 1.48-3.44), slightly smaller in Chinese (HR = 1.32; 95% CI, 1.08-1.62) and Filipino (HR = 1.31; 95% CI, 1.08-1.60) individuals, and similar in Japanese individuals (HR = 1.44; 95% CI, 1.15-1.81). Heterogeneity in this association across Asian subgroups may be related to type 2 diabetes severity. Understanding this heterogeneity may inform prevention strategies to prevent dementia for all racial and ethnic groups. [ABSTRACT FROM AUTHOR]
- Subjects :
- RISK assessment
STATISTICAL models
ASIAN Americans
RESEARCH funding
HEALTH status indicators
SEX distribution
HYPERTENSION
WHITE people
CHINESE Americans
SOUTH Asian Americans
DESCRIPTIVE statistics
SEVERITY of illness index
DISEASE prevalence
AGE distribution
ECONOMIC status
JAPANESE Americans
TYPE 2 diabetes
SENILE dementia
CONFIDENCE intervals
DATA analysis software
STROKE
DISEASE incidence
FILIPINO Americans
PROPORTIONAL hazards models
EDUCATIONAL attainment
DISEASE risk factors
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 00029262
- Volume :
- 193
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- American Journal of Epidemiology
- Publication Type :
- Academic Journal
- Accession number :
- 179421698
- Full Text :
- https://doi.org/10.1093/aje/kwae051