ArticleFrontiers in aging neuroscience2026
Long-term risk of incident dementia following documented COVID-19 among older adults with type 2 diabetes: a propensity score-matched cohort study.
Article in Frontiers in aging neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Type 2 diabetes mellitus (T2DM) is a well-established risk factor for dementia, and COVID-19 has been associated with persistent neurological and cognitive sequelae. However, whether this association extends beyond the early post-infection period among older adults with T2DM-a population with compounded vascular and metabolic vulnerability-remains unclear. Methods: Using the TriNetX Global Collaborative Network, we conducted a retrospective cohort study of patients aged ≥65 years with T2DM, comparing those with documented COVID-19 to a matched unexposed cohort (1:1 propensity score matching). A 1-year landmark design was applied, with follow-up extending to 6 years after the index date. The primary outcome was incident overall dementia, which is a composite of vascular dementia, Alzheimer's disease, and unspecified/other dementia. The secondary outcomes included individual dementia subtypes, mild cognitive impairment, all-cause mortality, and cerebral infarction. Results: After matching, 449,745 patients were included in each group with well-balanced covariates (all standardized mean differences <0.1). Documented COVID-19 was associated with a significantly increased risk of overall dementia [hazard ratio (HR 1.51), 95% confidence interval (CI) 1.47-1.55, Conclusion: In this large propensity score-matched cohort study, documented COVID-19 was associated with an increased long-term risk of incident dementia among older adults with T2DM, with the association persisting and strengthening beyond the early post-infection period. These findings support sustained attention to cognitive health in this metabolically susceptible population following COVID-19; however prospective studies incorporating standardized cognitive and biomarker assessments are needed to clarify underlying causes.
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