Associations of glycaemia‐related risk factors with dementia and cognitive decline in individuals with type 2 diabetes: A systematic review and meta‐analysis
Authors' conclusion
Having a history of hypoglycaemia, longer diabetes duration, and higher HbA1c levels and variability were related to higher dementia risk in people with type 2 diabetes.
Study context
- Population
- People with T2D in prospective studies; Embase and MEDLINE searched January 2000–October 2024
- Participants
- 7,076,724 people40 studies
- Comparison
- Glycaemia-related exposures and dementia/cognitive decline
- Outcome
- Cognitive decline, all-cause dementia, AD or vascular dementia (VaD)
Methodological detailsrandom-effects model, meta-regression
- Random-effects model
- Meta-regression
Pooled result
As reported in the abstract
- Hypoglycaemia: higher risk of all-cause dementia
- 49%
- Hypoglycaemia: higher risk of Alzheimer's disease (AD)
- 31%
- Pooled effect size did not vary by age, sex, diabetes duration, smoking, follow-up length, hypertension, kidney disease, dyslipidaemia or stroke
- all p > 0.05
- Hypoglycaemia frequency and all-cause dementia: maximum hazard ratios (HRs) in highest exposure group
- 2.36-2.60
Further pooled results
HbA1c and all-cause dementia
- Positive risk gradient; maximum significant HRs for highest category
- 1.40-3.88
- Pooled HR (95% CI), 3 studies
- 1.18 (0.97, 1.45)
HbA1c variability and diabetes duration and dementia
- Each significantly associated with higher dementia risk
Cognitive decline
- Limited evidence for a relationship with glycaemia-related factors
Original publication
Associations of glycaemia‐related risk factors with dementia and cognitive decline in individuals with type 2 diabetes: A systematic review and meta‐analysis. Diabet Med. Published 19 August 2025. doi:10.
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