科研之友
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摘要
Aims To determine whether diabetes mellitus influences functional status in patients with Alzheimers disease. Methods We studied 608 community-dwelling patients with Alzheimers disease from a prospective multicenter cohort. Diabetes was assessed at baseline. Functional status was assessed twice yearly with the Activities of Daily Living scale. Each patient had a baseline functional disability if their Activities of Daily Living score was %26lt; 6. Progression of functional disability was defined by a decreased Activities of Daily Living score over 4 years of follow-up visits. Results At baseline, diabetes was present in 63 participants (10.4%) and, compared with those without diabetes, was associated with functional impairment [age- and sex-adjusted OR = 2.73 (95% CI 1.415.28)]. After controlling for confounders, the association remained significant [OR = 2.04 (95% CI 1.024.11)]. Follow-up demonstrated a significant interaction between duration of Alzheimers disease and diabetes, which was associated with progression of functional impairment in patients who had been diagnosed with Alzheimers disease for less than 1 year [age- and sex-adjusted hazard ratio = 1.52 (95% CI 1.012.30), P = 0.048], but not in those who had been diagnosed with Alzheimers disease for more than 1 year [age- and sex-adjusted hazard ratio = 0.78 (95% CI 0.471.28), P = 0.32]. Abnormal one-leg balance, polymedication and obesity seem to be important factors explaining the association between diabetes and functional status. Conclusions At baseline, the presence of diabetes significantly increases the risk of functional disability in patients with Alzheimers disease; our longitudinal data confirm that in patients with a recent diagnosis of Alzheimers disease (but not in those who have had Alzheimers disease for longer than 1 year), diabetes continues to worsen functional status.
- 出版日期2012-4
