Hypoglycemic event in elderly raises dementia risk

Older adults with diabetes mellitus may be at increased risk for Alzheimer’s disease or vascular dementia following a hypoglycemic event, according to a study published online by JAMA Internal Medicine on June 10th.

Kristine Yaffe, MD, Department of Psychiatry, University of California, San Francisco, and colleagues decided to study the association between severe hypoglycemia and dementia in a group of independent elderly adults who had diabetes but no dementia. They hypothesized that severe hypoglycemic events would be linked to an increased risk of dementia. In addition, those who developed dementia had an increased risk for severe hypoglycemia.

In this prospective population-based study, 783 elderly with diabetes were followed over 12 years. During that time, 61 older patients experienced a hypoglycemic event (7.8%) and 148 were diagnosed with dementia (18.9%).

“Older adults with DM who had a hypoglycemic event resulting in hospitalization were more likely to develop dementia (21 of 61 [34.4%]) compared with 127 of 722 [17.6%] among those who did not have a hypoglycemic event (P<.001),” Dr. Yaffe wrote.

The researchers also found that there was a greater risk for subsequent severe hypoglycemic events in elderly who had been diagnosed with dementia than in those who had not been diagnosed (14.2% vs 6.3%, P<.001), according to the study.

“Our findings emphasize the importance of cognitive function in the clinical management of older adults with DM. Certain medications known to carry a higher risk for hypoglycemia, such as insulin secretagogues and some sulfonylureas, may be inappropriate for older patients with or at risk for cognitive impairment,” the authors said.