Introduction and Objective: Dementia, an emerging complication of type 2 diabetes (T2D), may be driven by chronic hyperglycemia and insulin resistance. We evaluated the risk of dementia across T2D subtypes, which differ in clinical profiles and risk of vascular complications.Methods: We identified newly diagnosed T2D (n = 727,076; age: 64.4 years [SD:13.3], 52% female) over 2012-2023 from the Epic Cosmos platform and classified them into Severe Insulin-Deficient Diabetes (SIDD, 21.6%), Mild Obesity-Related Diabetes (MOD, 23.8%), Mild Age-Related Diabetes (MARD, 40.9%) or Unclassified (i.e., Mixed; 13.7%). First occurrence of any dementia and also specific risks of vascular dementia, Alzheimer’s, and other dementias within ten years after T2D diagnosis were identified using ICD-10-CM codes. Cox proportional hazards models were used to estimate covariate-adjusted absolute and relative hazards (HR) by subtype.Results: Compared with MOD, SIDD (HR: 2.25 [95%CI: 1.92, 2.64]) and MARD (2.00 [1.70, 2.34]) had higher hazards for any dementia (Figure). Unclassified diabetes showed intermediate hazards of any dementia (1.38 [1.16, 1.65]). Risks of vascular, Alzheimer’s, and other dementias were also higher in SIDD and MARD compared to MOD and Unclassified diabetes.Conclusion: T2D subtypes differ in dementia risks, emphasizing the need for research into tailored prevention strategies and early screening, particularly for SIDD and MARD.
Z. Li: None. B. Salazar: None. J. Guo: None. K.O. Sanaka: None. A. Kahkoska: None. P. Vellanki: Advisory Panel; Eli Lilly and Company. M.K. Ali: Advisory Panel; Eli Lilly and Company. J. Varghese: None.
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