Alzheimer Disease
Conditions
Keywords
Diabetes mellitus, Alzheimer Disease or related disorders
Brief summary
Along with population ageing, the association of chronic conditions such as Alzheimer's Disease and Related Syndromes (ADRS) and diabetes mellitus is increasing in clinical practice. According to ADRS severity, guidelines of diabetes care may be adapted for a personalized monitoring and treatment. The consequences on diabetes complications are not known and can also threaten dementia progression. Based on a nationwide healthcare reimbursement database, the present study aimed to compare diabetes care and the incidence of acute complications between patients with or without ADRS, in a longitudinal perspective focusing on the pivotal period of ADRS identification by the healthcare system.
Interventions
OTHERIncidence analysis
Incidence analysis between the 2 groups (ADRS/non ADRS). For each pair, an index date was defined as the ADRS identification date. In both groups, a 5-year period free of these three ADRS criteria was required before the index date, to ensure incident ADRS cases.
Sponsors
Institut National de la Santé Et de la Recherche Médicale, France
University Hospital, Toulouse
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* individuals with a first ADRS criterion in 2011 or 2012, * prevalent diabetes mellitus, defined by a LTD with ICD-10 codes of diabetes mellitus (E10-E14). * at least one reimbursement in the year preceding inclusion.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diabetes control | one year | Given the absence of consensual guidelines describing the frequency of diabetes monitoring among elderly subjects, we defined a conservative minimal threshold as follows: ambulatory biological monitoring : * ≥ 1 annual HbA1c determination (primary endpoint) * ≥ 2 annual HbA1c determination * ≥ 1 annual lipid profile (≥ 1 annual LDL cholesterol, ≥ 1 annual triglyceride) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hypoglycemia | one year | ≥ 1 annual hospitalization for hypoglycemia |
| ketoacidosis without coma | one year | ≥ 1 annual hospitalization for ketoacidosis without coma |
| diabetic coma | one year | \- ≥ 1 annual hospitalization for diabetic coma (with ketoacidosis, hyperosmolar or hypoglycemia) |
| Ocular Diabetes complications | one year | ≥ 1 annual eye examination, defined by a visit to an ophthalmologist or a dilated fundus examination, in or out of the hospitals |
| diabetic neuropathy | one year | ≥ 1 annual hospitalization for diabetic neuropathy |
| hospitalization for any of the 5 previous diabetes-related cause | one year | ≥ 1 annual hospitalization for any of the 5 previous diabetes-related cause |
| hospitalization for falls and femoral fracture | one year | ≥ 1 annual hospitalization for falls and femoral fracture |
| diabetic nephropathy | one year | ≥ 1 annual hospitalization for diabetic nephropathy |
Countries
France
Outcome results
None listed