Bri Bronsky, Cristin Adams, and Corinne McGill The Link Between Poorly Controlled Type II Diabetes and Alzheimer’s Disease Bri Bronsky, Cristin Adams, and Corinne McGill

Poorly Controlled Type 2 Diabetes = Risk of Alzheimer’s Disease Study Question Does poorly controlled type 2 diabetes increase the risk of developing Alzheimer’s disease in adults aged 65-75 compared to those with controlled diabetes? Hypothesis H0: Rexp= Runexp HA: Rexp> Runexp Poorly Controlled Type 2 Diabetes = Risk of Alzheimer’s Disease

Exposure Outcome Uncontrolled Diabetes (A1C > 9 ) Clinical Diagnosis of Alzheimer’s Disease

Study Design - Prospective Cohort Diabetic Positron emission tomography (PET)

Data Analysis Main exposure: uncontrolled or controlled DM Dichotomous variable Primary outcome: diagnosis of AD or no diagnosis of AD Measure of association: risk ratio Runcontrolled DM/ Rcontrolled DM Covariates Hypertension, hyperlipidemia, obesity, family history of AD Sample size estimate: 47,180 individuals (see next slide)

From https://www.openepi.com/SampleSize/SSCohort.htm

Problems, Pitfalls, Limitations High cost given numbers and proposed testing Large number of people required given relatively low incidence AD Variable blood sugar control over time Medication differences Patients inevitably lost to follow up Those with dementia may be more likely to be lost to follow up Bias is toward the null

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