Editorials

Diabetes, cognitive impairment, and dementia

BMJ 2008; 336 doi: http://dx.doi.org/10.1136/bmj.39386.664016.BE (Published 03 January 2008) Cite this as: BMJ 2008;336:6
  1. Mark W J Strachan, consultant physician1,
  2. Jacqueline F Price, clinical senior lecturer in epidemiology2,
  3. Brian M Frier, honorary professor of diabetes3
  1. 1Metabolic Unit, Western General Hospital, Edinburgh EH4 2XU
  2. 2University of Edinburgh, Edinburgh EH8 9AG
  3. 3Royal Infirmary of Edinburgh, Edinburgh EH16 4SG
  1. mark.strachan{at}luht.scot.nhs.uk

    Are strongly linked, but the precise mechanisms are unclear

    The Dementia UK report, published earlier this year on behalf of the Alzheimer’s Society, predicts that by 2050, 34 million people worldwide will have dementia, and 71% of these people will live in developing countries.1 Currently, nearly 700 000 people have dementia in the United Kingdom, and worldwide this figure approaches 18 million. Dementia costs the UK economy around £17bn (€24bn; $35bn) each year, but the human cost to patients, their families, and their friends is incalculable.

    Over the past 15 years, several studies have indicated that diabetes mellitus, particularly type 2 diabetes, is associated with an increased risk of cognitive impairment and dementia.234 If these studies are correct, then the future burden of dementia may be even greater than estimated as the prevalence of type 2 diabetes continues to rise.

    Early data that linked type 2 diabetes with cognitive impairment came from cross sectional cohort studies that were generally of poor methodological quality.4 However, a recent systematic review of prospective observational studies identified 25 articles that assessed the …

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