%0 Journal Article
%T Heterogeneity in the effect of type 2 diabetes on dementia incidence in a diverse cohort of Asian American and non-Latino White older adults.
%A Hayes-Larson E
%A Zhou Y
%A Wu Y
%A Mobley TM
%A Gee GC
%A Brookmeyer R
%A Whitmer RA
%A Gilsanz P
%A Kanaya AM
%A Mayeda ER
%J Am J Epidemiol
%V 0
%N 0
%D 2024 Apr 17
%M 38949483
%F 5.363
%R 10.1093/aje/kwae051
%X Dementia incidence is lower among Asian Americans than Whites, despite higher prevalence of type 2 diabetes, a well-known dementia risk factor. Determinants of dementia, including type 2 diabetes, have rarely been studied in Asian Americans. We followed 4,846 Chinese, 4,129 Filipino, 2,784 Japanese, 820 South Asian, and 123,360 non-Latino White members of a California-based integrated healthcare delivery system from 2002-2020. We estimated dementia incidence rates by race/ethnicity and type 2 diabetes status, and fit Cox proportional hazards and Aalen additive hazards models for the effect of type 2 diabetes (assessed 5 years before baseline) on age of dementia diagnosis controlling for sex/gender, educational attainment, nativity, height, race/ethnicity, and a race/ethnicity*diabetes interaction. Type 2 diabetes was associated with higher dementia incidence in Whites (hazard ratio [HR] 1.46, 95% confidence interval [CI] 1.40-1.52). Compared with Whites, the estimated effect of diabetes was larger in South Asians (2.26 [1.48-3.44]), slightly smaller in Chinese (1.32 [1.08-1.62]) and Filipino (1.31 [1.08-1.60]), and similar in Japanese (1.44 [1.15-1.81]) individuals. Heterogeneity in this association across Asian subgroups may be related to type 2 diabetes severity. Understanding this heterogeneity may inform prevention strategies to prevent dementia for all racial and ethnic groups.