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oai:figshare.com:article/33771667 2026-09-15T05:34:08Z category_15 portal_316 item_type_3 month_year_09_2026

Supplementary file 1_Long-term risk of incident dementia following documented COVID-19 among older adults with type 2 diabetes: a propensity score-matched cohort study.docx I-Wen Chen (9548687) Li-Chen Chang (23595883) Chun-Ning Ho (14348433) Kuo-Chuan Hung (8587392) Neuroscience cohort study COVID-19 dementia propensity score matching TriNetX type 2 diabetes mellitus Background<p>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.</p>Methods<p>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.</p>Results<p>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, p < 0.001]. The secondary outcomes were similarly elevated, such as vascular dementia (HR 1.61), Alzheimer’s disease (HR 1.41), mild cognitive impairment (HR 1.66), all-cause mortality (HR 1.56), and cerebral infarction (HR 1.33; all p < 0.001). The hazard ratio for overall dementia increased progressively across sequential landmark periods (1.51 at 1 year, 1.66 at 2 years, and 2.09 at 3 years), and the findings remained robust across sensitivity analyses, addressing survival, healthcare utilization, and exposure misclassification. The findings were consistent in separately constructed and propensity score-matched additional cohorts restricted to adults aged 50–65 years and to patients indexed during the Omicron-predominant period.</p>Conclusion<p>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.</p> 2026-09-15T05:34:08Z Dataset Dataset 10.3389/fnagi.2026.1927383.s001 https://figshare.com/articles/dataset/Supplementary_file_1_Long-term_risk_of_incident_dementia_following_documented_COVID-19_among_older_adults_with_type_2_diabetes_a_propensity_score-matched_cohort_study_docx/33771667 CC BY 4.0