By: Ed Susman

VANCOUVER, BRITISH COLUMBIA, CANADA – Elderly patients with diabetes who have peripheral arterial disease have a 72% greater risk of developing dementia than individuals who do not have the complication linked to heart disease, researchers at the 2012 Alzheimer’s Association International Conference.

“We found that these patients with peripheral arterial disease are at increased risk of dementia, independent of sociodemographics, complications of diabetes, and vascular comorbidities,” said Lieza Exalto, MD, Utrecht Medical Center, Utrecht, the Netherlands.

Probing the Kaiser Permanente Northern California Diabetes Registry, Dr. Exalto and colleagues compared 28,119 patients who did not have peripheral arterial disease with 1,842 patients who exhibited the vascular complication. The prospective cohort was entered in the registry between 1996 and 2008. Hospital coding was used to determine cases of peripheral arterial disease and dementia.

“We know that peripheral artery disease in the general population is a risk factor for dementia, but the data are unclear about whether that relationship holds true for individuals with diabetes,” Dr. Exalto said at her poster presentation.

The researchers found that 17% of the patients without peripheral arterial disease developed dementia compared with 20% of those individuals with peripheral arterial disease (P <.001).

“The association between dementia risk and peripheral arterial disease in diabetes may reflect a potential etiological role of vascular injury in dementia in diabetes,” Dr. Exalto said.

The average age of the individuals without peripheral arterial disease was 70.4 years which was significantly younger than those who had peripheral arterial disease (72.4 years; P <.0001).

More of the patients (47%) without peripheral arterial disease were women compared with those who had peripheral arterial disease (33%; P <.0001). Those without peripheral arterial disease had a shorter duration of a diabetes diagnosis (11.3 years) compared with those with peripheral arterial disease (14.9 years; P <.0001). There was no significant difference in glycosylated haemoglobin A1C levels between the 2 groups.

The researchers adjusted their model to account for age, gender, race, education level, medical utilisation, diabetes related factors, and vascular related factors.

Dr. Exalto suggested that clinicians should recognise the role that peripheral arterial disease plays in development of dementia and to counsel patients accordingly.

- MFP Wire Services
- 07-27-2012