U.S. research team: โThe greater the social disadvantage, the higher the risk of dementiaโฆ The association is stronger in women.โ
(Seoul = Yonhap News) Reporter Jooyoung Lee = Among people with type 2 diabetes (T2D), those with disadvantaged social environments such as income, regional education-related deprivation, housing conditions, loneliness, and stress have a higher risk of dementia, and this association was found to be much stronger in women than in men.
On the 2nd, Professor Ilin Yoshida's team at Tulane University in the international journal Aging announced that they had confirmed this relationship by tracking the relationship between social determinants of health (SDOH) and the occurrence of dementia for 21,000 UK Biobank participants for 14 years.
The research team said that this study shows that women with type 2 diabetes may be particularly vulnerable to cognitive risk related to adverse social determinants of health, and that it is necessary to look at the patient's social environment in addition to medical indicators when assessing the risk of dementia in diabetic patients.
Patients with type 2 diabetes have a significantly higher risk of dementia and other cognitive disorders compared to people without diabetes. In particular, as diabetes management improves and survival rates increase, the number of patients reaching an age where dementia and cognitive decline are common is expected to increase.
The research team followed 10,071 UK Biobank participants with type 2 diabetes and 11,780 normal blood sugar participants for about 14 years to determine the relationship between social determinants of health (SDOH) and the occurrence of dementia.
SDOH synthesizes various social conditions such as income, education, accessibility to medical services, housing and local environment, and social relationships into one score. The higher the score, the more unfavorable the social environment was, and the participants were divided into three groups: advantageous, middle, and unfavorable.
During the follow-up period, 247 participants with type 2 diabetes and 149 participants with normoglycemia developed dementia.
As a result of the analysis, among patients with type 2 diabetes, the group with the most disadvantageous social environment had a risk of developing dementia about 2.4 times higher than the group with the most advantageous social environment. A significant association was found even after taking into account demographic and lifestyle factors, diabetes-related factors, and genetic risk of dementia.
In particular, among patients with type 2 diabetes, women in disadvantaged social environments had a risk of dementia that was 5.35 times higher than those in favorable social environments. In men with type 2 diabetes, the risk of dementia in an unfavorable social environment was 1.70 times higher than in a favorable social environment.
Additionally, in groups with moderate or unfavorable social environments, the risk of dementia was 2.89 times higher for patients with type 2 diabetes than for those with normal blood sugar, and when looking only at women, the risk of dementia for women with type 2 diabetes was 3.11 times higher than for women with normal blood sugar.
Among individual social factors, household income, local educational environment, and homeownership were associated with the risk of dementia in patients with type 2 diabetes. Loneliness and subjectively perceived stress were also associated with the risk of dementia, with loneliness having a stronger association in women.
The research team explained that social disadvantage can affect access to medical services, healthy food, physical activity, and medication use, and can increase psychosocial stress, and that these factors are likely to work together with type 2 diabetes to affect brain health.
However, because this study is an observational study, the influence of unmeasured factors cannot be completely ruled out, and the participants do not completely represent the general population, he said. This result does not mean that social disadvantage directly causes dementia.
As the relationship between social disadvantage and dementia risk was particularly strong in women with type 2 diabetes, the research team suggested that social conditions and gender need to be considered together in future diabetes management and cognitive function risk assessment.
โ Source: Aging, Yilin Yoshida et al., 'Social determinants of health and risk of dementia in people with and without type 2 diabetes - findings from two large national-scale cohorts', https://doi.org/10.18632/aging.206417
