1253-P: Differential Risk of Dementia in Older Adults with Diabetes by Race/Ethnicity, Gender, and Age—Health and Retirement Study 1992–2020

While it is known that adults with diabetes have two times the risk of developing dementia compared to adults without diabetes, it is unknown whether the risk differs by race/ethnicity, gender, and age amongst older adults with diabetes. The aim of this analysis was to determine the risk of developing dementia in older adults with diabetes and to determine whether the risk differs by race/ethnicity, gender, and age. Data from the Health and Retirement Study(1992-2020) Harmonized Cognitive Assessment Protocol participants aged 50 and older were used (n=3496). Time to dementia was the dependent variable. The primary independent variable was diabetes (yes/no). Covariates included race/ethnicity, gender, age, education, employment, metropolitan statistical area, and region. Unadjusted and fully adjusted Cox proportional hazards models were run. Interactions between diabetes and race/ethnicity, gender, and age were tested. Models with significant interactions were stratified. Analyses were conducted using Stata v17.0, and statistical significance was p-value<0.05.In unadjusted models, older adults with diabetes had 24% increased risk of developing dementia (HR 1.24; 95%CI 1.03,1.50) compared to those without diabetes. There was a significant interaction between diabetes and age. Fully adjusted, age stratified models showed adults with diabetes aged 50-64 (HR 1.73; 95%CI 1.01,2.95) and 65-74 years (HR 1.39; 95%CI: 1.02,1.88) had increased risk of developing dementia compared to those without diabetes; and there was no association for adults aged 75 and older. The effect of diabetes on dementia happens earlier in age, is more prominent in older adults aged 50 -74, and does not have an impact in older age groups (75 years and older). Targeted intervention is critical and may be more beneficial in older adults aged 50-74, and there is need for early recognition of cognitive decline in this population to mitigate adverse outcomes.