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Racial/ethnic differences in dementia risk among older type 2 diabetic patients: the diabetes and aging study
Mayeda ER, Karter AJ, Huang ES, Moffet HH, Haan MN, Whitmer RA.. Diabetes care, 2013-11-22
Topic: Risk, prevention and care in population studies
OBJECTIVE Although patients with type 2 diabetes have double the risk of dementia, potential racial/ethnic differences in dementia risk have not been explored in this population. We evaluated racial/ethnic differences in dementia and potential explanatory factors among older diabetic patients. RESEARCH DESIGN AND METHODS We identified 22,171 diabetic patients without preexisting dementia aged ≥60 years (14,546 non-Hispanic whites, 2,484 African Americans, 2,363 Latinos, 2,262 Asians, 516 Native Americans) from the Kaiser Permanente Northern California Diabetes Registry. We abstracted prevalent medical history (1 January 1996 to 31 December 1997) and dementia incidence (1 January 1998 to 31 December 2007) from medical records and calculated age-adjusted incidence densities. We fit Cox proportional hazards models adjusted for age, sex, education, diabetes duration, and markers of clinical control. RESULTS Dementia was diagnosed in 3,796 (17.1%) patients. Age-adjusted dementia incidence densities were highest among Native Americans (34/1,000 person-years) and African Americans (27/1,000 person-years) and lowest among Asians (19/1,000 person-years). In the fully adjusted model, hazard ratios (95% CIs) (relative to Asians) were 1.64 (1.30-2.06) for Native Americans, 1.44 (1.24-1.67) for African Americans, 1.30 (1.15-1.47) for non-Hispanic whites, and 1.19 (1.02-1.40) for Latinos. Adjustment for diabetes-related complications and neighborhood deprivation index did not change the results. CONCLUSIONS Among type 2 diabetic patients followed for 10 years, African Americans and Native Americans had a 40-60% greater risk of dementia compared with Asians, and risk was intermediate for non-Hispanic whites and Latinos. Adjustment for sociodemographics, diabetes-related complications, and markers of clinical control did not explain observed differences. Future studies should investigate why these differences exist and ways to reduce them.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Mayeda, E. R., Karter, A. J., Huang, E. S., Moffet, H. H., Haan, M. N., & Whitmer, R. A. (2014). Racial/ethnic differences in dementia risk among older type 2 diabetic patients: the diabetes and aging study. Diabetes care. https://doi.org/10.2337/dc13-0215
Vancouver
Mayeda ER, Karter AJ, Huang ES, Moffet HH, Haan MN, Whitmer RA. Racial/ethnic differences in dementia risk among older type 2 diabetic patients: the diabetes and aging study. Diabetes care. 2014. doi:10.2337/dc13-0215. PMID: 24271192.
BibTeX
@article{mayeda2014-24271192,
author = {Mayeda, E. R. and Karter, A. J. and Huang, E. S. and Moffet, H. H. and Haan, M. N. and Whitmer, R. A.},
title = {{Racial/ethnic differences in dementia risk among older type 2 diabetic patients: the diabetes and aging study}},
journal = {Diabetes care},
year = {2014},
doi = {10.2337/dc13-0215},
pmid = {24271192},
url = {https://doi.org/10.2337/dc13-0215}
}
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Key findings
- RESULTS Dementia was diagnosed in 3,796 (17.1%) patients.
- Adjustment for diabetes-related complications and neighborhood deprivation index did not change the results.
- CONCLUSIONS Among type 2 diabetic patients followed for 10 years, African Americans and Native Americans had a 40-60% greater risk of dementia compared with Asians, and risk was intermediate for non-Hispanic whites and Latinos.
Why it matters
In 22,171 people aged 60+ with type 2 diabetes in the Kaiser Permanente Northern California registry, followed for about 10 years, 17.1% were diagnosed with dementia. Native Americans (hazard ratio 1.64) and African Americans (1.44) had the highest risk relative to Asians, with non-Hispanic whites (1.30) and Latinos (1.19) in between. The study reports that accounting for diabetes complications and neighborhood deprivation did not change these differences. It shows an association within one health system, not a cause, and tests no treatment.
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Study details
- Effect size17.1%
- Evidence strengthLow
How this study scored 51/100
Published in a leading specialty journal. Scored zero for study design, sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Diabetes care) |
| Journal's citation record | 4 / 4 | Diabetes Care: journal h-index 509 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2014 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 83 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.9 citations a year over 14 year(s) since 2014 |
| Impact for its field and year | 3 / 6 | Cited 3.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 9 other studies in this library |
| Still being cited | 2 / 4 | Cited 15 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Rachel A. Whitmer: h-index 63 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 24271192) |
| Free to read | 2 / 2 | Free to read |
| Total | 51 / 100 | — |
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