Prediabetes and the risk of dementia

Is prediabetes is already associated with an increased risk of dementia, or is subsequent development of type 2 diabetes the primary cause?

Dementia risk with prediabetes

Prediabetes: problematic for body and mind

More and more adults - and young people too - are suffering from prediabetes. And many of them don't even know it. An unbalanced diet and little exercise contribute to the development of the sugar metabolism disorder. In many cases, prediabetes develops into manifest type 2 diabetes. This is particularly true for those affected who are not aware of their condition or who do not make any lifestyle changes. Physical and mental symptoms such as obesity, organ damage or depression can be the result, in addition to full-blown diabetes. It is also increasingly being discussed whether prediabetes increases the risk of dementia.

Prediabetes or diabetes: which is responsible for dementia?

The question often arises: is prediabetes in itself is already a risk factor for dementia later on? or is it the fact that manifest diabetes often follows the precursor stage? The authors of a recent study have investigated these questions.

Why should the results be treated with caution?

The researchers analysed data from over 11,500 people who did not have diabetes at the start of the study. Over the course of the study, it was found that prediabetes was associated with a significantly higher risk of dementia.

However, the study authors make it clear that these results need to be put into perspective. The increased incidence of dementia in prediabetics can be explained by the fact that in most cases prediabetes progresses to manifest diabetes. And - unsurprisingly - the longer the metabolic disorder persists, the greater the risk of dementia.

Take away for medical practice

Prediabetes can be clearly associated with an increased risk of developing dementia. However, the current study makes it clear that this can be explained by the development of manifest type 2 diabetes. Rather, the high number of unreported cases of prediabetes appears to be problematic. The longer the metabolic disorder persists, the greater the risk of dementia in the course of the disease.

Source
  1. Hu J, Fang M, Pike JR, Lutsey PL, Sharrett AR, Wagenknecht LE, Hughes TM, Seegmiller JC, Gottesman RF, Mosley TH, Coresh J, Selvin E. Prediabetes, intervening diabetes and subsequent risk of dementia: the Atherosclerosis Risk in Communities (ARIC) study. Diabetologia. 2023 Aug;66(8):1442-1449. doi: 10.1007/s00125-023-05930-7. Epub 2023 May 24. PMID: 37221246.