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Mild cognitive impairment and progression to dementia in people with diabetes, prediabetes and metabolic syndrome: a systematic review and meta-analysis

Pal, K; Mukadam, N; Petersen, I; Cooper, C; (2018) Mild cognitive impairment and progression to dementia in people with diabetes, prediabetes and metabolic syndrome: a systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology , 53 (11) pp. 1149-1160. 10.1007/s00127-018-1581-3. Green open access

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Abstract

PURPOSE: We aimed to quantify the relative risk of progression from mild cognitive impairment (MCI) to dementia in people with and without diabetes, and with and without the MetS (MetS); and to identify potential modifiers of the risk of progression from MCI to dementia in people with diabetes or MetS. METHODS: We searched Medline, Embase, PsycINFO, PsycArticles and Web of Science from inception through to 20th March 2018. Where possible, the results from three or more studies were pooled in a meta-analysis, while other findings have been described narratively. RESULTS: We included 15 articles reporting 12 studies (6865 participants). The overall unadjusted pooled odds ratio for the progression of MCI to dementia in people with diabetes/MetS was 1.67 (95% CI 1.27-2.19); the pooled odds ratio for progression in diabetes + MCI was 1.53 (95% CI 1.20-1.97) and in people with MetS + MCI was 2.95 (95% CI 1.23-7.05). There was moderate heterogeneity in the included studies (I2 < 60%). In diabetes, a longer duration of diabetes and the presence of retinopathy were associated with an increased risk of progression, while the use of statins and oral hypoglycaemic agents reduced the risk. Having multiple cardiovascular risk factors was a significant risk factor for progression from MCI to dementia in people with MetS. CONCLUSIONS: Diabetes and MetS were both associated with an increased incidence of dementia when co-existing with MCI. Intensive cardiovascular risk reduction and lifestyle changes for patients presenting with MCI and diabetes, prediabetes or MetS may be important in reducing incidence of dementia in this high risk population.

Type: Article
Title: Mild cognitive impairment and progression to dementia in people with diabetes, prediabetes and metabolic syndrome: a systematic review and meta-analysis
Location: Germany
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00127-018-1581-3
Publisher version: http://dx.doi.org/10.1007/s00127-018-1581-3
Language: English
Additional information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Dementia, MCI, Meta-analysis, Systematic review, T2D
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Mental Health of Older People
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10055735
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