Gestational diabetes mellitus and risk of dementia in late life: a prospective cohort study of United Kingdom Biobank

Abstract Although it has been demonstrated that gestational preeclampsia increased the risk of dementia, there is limited information regarding the relation between history of gestational diabetes mellitus (GDM) and the risk of late life dementia. In the present study, we analyzed the correlation using United Kingdom (UK) Biobank data. Propensity score-based fine stratification weighting and a Cox proportional hazards regression model were used and the risk of dementia was presented by weighted hazard ratio (HR) with 95% confidence intervals (CIs). A multi-state model was then used to analyze the impact of GDM on the progression of dementia from diseases, including type 2 diabetes (T2DM), hypertension, stroke, and myocardial infarction (MI). The study cohort consisted of 1,177 women who were previously exposed to GDM and 217,728 women who were not previously exposed to GDM. Overall, the adjusted dementia risk was approximately 1.67- to 2.02-fold higher for women exposed to previous GDM than those not exposed. In particular, GDM exposure increased the risk for dementia among women who experienced postpartum T2DM (HR = 1.92, 95% CI = 1.05–3.53), hypertension (HR = 2.00, 95% CI = 1.13–3.55), and MI (HR = 3.16, 95% CI = 1.28–7.75). However, for women without the above postpartum complications, the risk of late life dementia did not increase. Therefore, GDM is associated with an increased risk of all-cause dementia, which may be attenuated by preventive measures against postpartum T2DM, hypertension, and MI. Barriers and strategies for preventing postpartum dementia-risk complications should be further evaluated in future studies.