Description of patients with dementia by diabetes status and cholinesterase inhibitor use
| Whole cohort: Diabetes (3176 patients) | P value | Whole cohort: Diabetes-free (19 484 patients) | P value | |||
| ChEI+ (2110 patients) | ChEI– (1066 patients) | ChEI+ (14 070 patients) | ChE – (5414 patients) | |||
| Age, years | 78.1 (6.9) | 81.4 (6.6) | <0.001 | 78 (7.8) | 83 (6.7) | <0.001 |
| Male sex | 932 (44.2%) | 489 (45.9%) | 0.36 | 5030 (35.7%) | 1963 (36.3%) | 0.51 |
| Living alone | 869 (41.2%) | 471 (44.2%) | <0.001 | 5937 (42.2%) | 2771 (51.2%) | <0.001 |
| Living with an adult | 1161 (55.0%) | 472 (44.3%) | 7649 (54.4%) | 2056 (38%) | ||
| At nursing home | 80 (3.8%) | 123 (11.5%) | 484 (3.4%) | 587 (10.8%) | ||
| Alzheimer’s disease | 1223 (58%) | 363 (34.1%) | <0.001 | 9531 (68.5%) | 2474 (45.7%) | <0.001 |
| Mixed dementia | 887 (42%) | 703 (65.9%) | 4439 (31.5%) | 2940 (54.3%) | ||
| MMSE score | 22 (6) | 20 (7) | <0.001 | 22 (6) | 20 (7) | <0.001 |
| Charlson comorbidity index | 2 (2) | 2 (3) | <0.001 | 1 (1) | 2 (2) | <0.001 |
| Antidiabetic medication | 1764 (83.6%) | 863 (81.0%) | 0.063 | |||
| Cardiovascular medication | 1942 (92.0%) | 1014 (95.1%) | 0.001 | 9240 (65.7%) | 4099 (75.7%) | <0.001 |
| Antithrombotic medication | 1422 (67.4%) | 827 (77.6%) | <0.001 | 6078 (43.2%) | 2982 (55.1%) | <0.001 |
| Antipsychotics | 77 (3.6%) | 76 (7.1%) | <0.001 | 533 (3.8%) | 398 (7.4%) | <0.001 |
| Hypnotics/sedatives | 521 (24.7%) | 321 (30.1%) | 0.001 | 3495 (24.8%) | 1639 (30.3%) | <0.001 |
| Diabetes duration | 6.0 (7.2) | 6.2 (8.5) | 0.046 | |||
| Median survival time, years | 4.5 (4.3–4.8) | 5.5 (5.4–5.6) | <0.001 | |||
| Died during follow-up | 778 (36.9%) | 570 (53.5%) | <0.001 | 4668 (33.2%) | 2562 (47.3%) | <0.001 |
| Cardiovascular mortality | 221 (10.5%) | 164 (15.4%) | <0.001 | 1077 (7.7%) | 669 (12.4%) | <0.001 |
| Diabetes mortality | 47 (2.2 %) | 41 (3.8%%) | 0.01 | |||
| Donepezil | 1294 (61.3%) | 8214 (58.4%) | 0.14 | |||
| Rivastigmine | 514 (24.4%) | 3736 (26.6%) | <0.001 | |||
| Galantamine | 529 (25.1%) | 4270 (30.3%) | <0.001 | |||
| ChEI PS matched: Diabetes (999 users/999 non-users) | P value | SMD | ChEI PS matched: Diabetes-free (5358 users/5,358 non-users) | P value | SMD | |||
| Age, years | 80.1 (6.4) | 80.9 (6.6) | 0.004 | −0.12 | 81.1 (7.2) | 82.5 (6.8) | <0.001 | −0.17 |
| Male sex | 451 (45.1%) | 449 (44.9%) | 0.93 | 0.01 | 2068 (38.7%) | 1942 (36.3%) | 0.02 | 0.05 |
| Living alone | 411 (41.1%) | 454 (45.4%) | 0.001 | 0.03 | 2521 (47.1%) | 2721 (50.9%) | <0.001 | −0.01 |
| Living with an adult | 528 (52.9%) | 456 (45.6%) | 2534 (47.4% %) | 2105 (39.4%) | ||||
| At nursing home | 60 (6.0%) | 89 (8.9%) | 293 (5.5%) | 522 (9.8%) | ||||
| Alzheimer’s disease | 444 (44.4%) | 372 (37.2%) | 0.006 | −0.15 | 2788 (52.1%) | 2598 (48.6%) | <0.001 | −0.08 |
| Mixed dementia | 555 (55.6%) | 627 (62.8%) | 2560 (47.9%) | 2750 (51.4 %) | ||||
| MMSE score | 21 (7) | 20 (7) | 0.11 | 0.08 | 21 (7) | 20 (7) | <0.001 | 0.13 |
| Charlson comorbidity index | 2 (2) | 2 (2) | 0.16 | −0.05 | 2 (2) | 2 (2) | 0.01 | −0.03 |
| Antidiabetic medication | 823 (82.4%) | 813 (81.4%) | 0.56 | 0.03 | ||||
| Cardiovascular medication | 939 (94.0%) | 946 (94.7%) | 0.5 | −0.03 | 3823 (71.5%) | 3976 (74.3%) | 0.001 | −0.06 |
| Antithrombotic medication | 722 (72.3%) | 756 (75.7%) | 0.08 | −0.07 | 2813 (52.6%) | 2878 (53.8%) | 0.21 | −0.03 |
| Antipsychotics | 54 (5.4%) | 60 (6.0%) | 0.56 | −0.03 | 320 (6.0%) | 335 (6.3%) | 0.55 | −0.02 |
| Hypnotics/sedatives | 269 (26.9%) | 278 (27.8%) | 0.65 | −0.02 | 1586 (29.7%) | 1570 (29.4%) | 0.73 | 0.01 |
| Diabetes duration | 6.3 (7.5) | 6.1 (8.3) | 0.95 | −0.01 | ||||
| Died during follow-up | 423 (42.3%) | 509 (51.0%) | <0.001 | 2150 (40.2%) | 2439 (45.6%) | <0.001 | ||
| Cardiovascular mortality | 130 (13%) | 140 (14%) | 0.51 | 563 (10.5%) | 641 (12%) | 0.017 | ||
| Diabetes mortality | 32 (3.2%) | 38 (3.8%) | 0.54 | |||||
| Donepezil | 615 (61.6%) | 3197 (59.8%) | ||||||
| Rivastigmine | 207 (20.7%) | 1269 (23.7%) | ||||||
| Galantamine | 243 (24.3%) | 1440 (26.9%) | ||||||
Age is described as mean (SD); MMSE score, Charlson index and diabetes duration (in years) are described as median (IQR); Median survival time is described as number of years with 95% CI; other variables are described as number of patients (%); PS-matched cohorts were matched on age, gender, cohabitation, dementia type, MMSE score, Charlson index, antipsychotics, hypnotics/sedatives, cardiovascular and antithrombotic medication and antidiabetic medication use and diabetes duration (last two variables included only in the DM cohort). SMD were calculated for the matching variables. The use of donepezil, rivastigmine and galantamine is compared in patients with DM and patients without DM.
ChEI, cholinesterase inhibitors; DM, diabetes mellitus; MMSE, Mini-Mental State Examination; PS, propensity score; SMD, standardized mean differences in PS-matched treated vs control subjects.