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K. Wang1,2, H. Liu1


1. Center of Medical Reproduction, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China, 400016; 2. Department of Neurosurgery, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA, USA, 02115.

Corresponding Author: Hong Liu, MD, PhD, Center of Medical Reproduction, the First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, China, 400016,

J Prev Alz Dis 2022;
Published online April 28, 2022,


Dear Editor,

We welcome the interest of Dr Kawada in our recent publication (1). They added some latest information about our study and some concerns as well. We intend to clarify and interpret them thoroughly.
Barbiellini Amidei et al conducted a prospective study showing that younger age at onset of diabetes was significantly associated with a higher risk of subsequent dementia which is consistent with our research (2). First, Dr Kawada was concerned that the “Risk of dementia after T2D M onset was not observed within 10 years, and the magnitude of dementia risk change against the time of T2DM onset became smaller in the older population.” Actually, it is the results about persons who onset diabetes over 70 years old which cannot represent the early-onset group as we definite. In their research, the early-onset group (at 55 years old) was lack of long-term follow-up and shown higher risk than other groups according to the first 5 years after onset. Second, we do believe that stroke is a risk factor for dementia, especially vascular dementia. We did not intend to confirm if stroke is an independent variable for predicting dementia. Stroke was set as an outcome to indicate the vascular lesion since quite few vascular dementia cases in our cohort.
Reinke et al. investigated the relationship between the duration of diabetes onset and the risk of dementia instead of the time point of onset (3). And, from their result, the group that developed T2DM at 65–84 years old show a higher risk of dementia than the group at over 85 years old (0.924, 0.909–0.940 vs 0.899, 0.864–0.935). What’s more, it is a promising topic that the early onset of diabetes comorbidities could increase the risk of dementia compared to the late-onset.
Generally speaking, the age of diabetes onset could represent a potential indicator for prevention measures for dementia based on our and some other research. And large scale research is needed to verify our observations or results and to investigate the mechanisms underlying the reported associations.


Conflict of Interest Disclosures: The authors declare that they have no conflicts of interest.

Funding/Support: Chongqing Medical University Scholarship Fund for Development of Young Talents (XRJH201901).



1. Wang K, Liu H. Early-Onset Subgroup of Type 2 Diabetes and Risk of Dementia, Alzheimer’s Disease and Stroke: A Cohort Study. J Prev Alzheimers Dis 2021;8, 442-447, doi:10.14283/jpad.2021.35.
2. Barbiellini Amidei C, Fayosse A, Dumurgier J, Machado-Fragua MD, Tabak AG, van Sloten T, Kivimaki M, Dugravot A, Sabia S, Singh-Manoux A. Association Between Age at Diabetes Onset and Subsequent Risk of Dementia. JAMA 2021;325, 1640-1649, doi:10.1001/jama.2021.4001.
3. Reinke C, Buchmann N, Fink A, Tegeler C, Demuth I, Doblhammer G. Diabetes duration and the risk of dementia: a cohort study based on German health claims data. Age Ageing 2022;51, doi:10.1093/ageing/afab231.