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Risk of dementia among persons with diabetes mellitus: a population-based cohort study
Leibson CL, Rocca WA, Hanson VA, Cha R, Kokmen E, O'Brien PC, Palumbo PJ.. American journal of epidemiology, 1997-02-01
Topic: Risk, prevention and care in population studies
It is unclear whether persons with diabetes are at increased risk for dementia, including Alzheimer's disease. Existing studies are limited by small sample size, selection bias, and case-control designs. This population-based historical cohort study provides estimates of the risk of dementia and Alzheimer's disease associated with adult onset diabetes mellitus (AODM). The sample included all persons with AODM residing in Rochester, Minnesota, on January 1, 1970, plus all persons diagnosed in Rochester or who moved to Rochester with the diagnosis between January 1, 1970, and December 31, 1984. Individuals were followed through review of their complete medical records from AODM diagnosis until dementia onset, emigration, death, or January 1, 1985. Standardized morbidity ratios for dementia and Alzheimer's disease were calculated, using an expected incidence based on age- and sex-specific rates for the Rochester population. Poisson regression was used to estimate risks for persons with AODM relative to those without. Of the 1,455 cases of AODM followed for 9,981 person-years, 101 developed dementia, including 77 who met criteria for Alzheimer's disease. Persons with AODM exhibited significantly increased risk of all dementia (Poisson regression relative risk (RR) = 1.66, 95% confidence interval (CI) 1.34-2.05). Risk of Alzheimer's disease was also elevated (for men, R = 2.27, 95% CI 1.55-3.31; for women, RR = 1.37, 95% CI 0.94-2.01). These findings emphasize the importance of AODM prevention and prompt additional investigation of the relation between AODM and dementia.
Key findings
- It is unclear whether persons with diabetes are at increased risk for dementia, including Alzheimer's disease.
- This population-based historical cohort study provides estimates of the risk of dementia and Alzheimer's disease associated with adult onset diabetes mellitus (AODM).
- Persons with AODM exhibited significantly increased risk of all dementia (Poisson regression relative risk (RR) = 1.66, 95% confidence interval (CI) 1.34-2.05).
- These findings emphasize the importance of AODM prevention and prompt additional investigation of the relation between AODM and dementia.
Why it matters
In 1,455 people with adult-onset diabetes in Rochester, Minnesota, followed through their medical records between 1970 and 1985, the risk of any dementia was about 1.7 times that of people without diabetes (RR 1.66, 95% CI 1.34–2.05). Alzheimer's risk was clearly higher in men (RR 2.27, 95% CI 1.55–3.31) but not clearly so in women (RR 1.37, 95% CI 0.94–2.01). This shows an association, not that diabetes causes dementia; the authors say it emphasizes the importance of preventing adult-onset diabetes and calls for more research.
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Study details
- Study designcohort study
- Effect sizeRR = 1.37
- Evidence strengthModerate
How this study scored 62/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (American journal of epidemiology) |
| Journal's citation record | 3 / 4 | American Journal of Epidemiology: journal h-index 416 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1997 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| 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 | 6 / 7 | Cited 701 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 22.6 citations a year over 31 year(s) since 1997 |
| Impact for its field and year | 4 / 6 | Cited 13.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 46 other studies in this library |
| Still being cited | 2 / 4 | Cited 31 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Pasquale J Palumbo: h-index 50 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Mayo Clinic: institution h-index 1,606 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 9054233) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 62 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Leibson, C. L., Rocca, W. A., Hanson, V. A., Cha, R., Kokmen, E., O'Brien, P. C., et al. (1997). Risk of dementia among persons with diabetes mellitus: a population-based cohort study. American journal of epidemiology. https://doi.org/10.1093/oxfordjournals.aje.a009106
Vancouver
Leibson CL, Rocca WA, Hanson VA, Cha R, Kokmen E, O'Brien PC, et al. Risk of dementia among persons with diabetes mellitus: a population-based cohort study. American journal of epidemiology. 1997. doi:10.1093/oxfordjournals.aje.a009106. PMID: 9054233.
BibTeX
@article{leibson1997-9054233,
author = {Leibson, C. L. and Rocca, W. A. and Hanson, V. A. and Cha, R. and Kokmen, E. and O'Brien, P. C. and Palumbo, P. J.},
title = {{Risk of dementia among persons with diabetes mellitus: a population-based cohort study}},
journal = {American journal of epidemiology},
year = {1997},
doi = {10.1093/oxfordjournals.aje.a009106},
pmid = {9054233},
url = {https://doi.org/10.1093/oxfordjournals.aje.a009106}
}
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