# The Impact of Type 2 Diabetes Mellitus on the Severity of Alzheimer’s Disease in Hispanic Populations in the Rio Grande Valley: A Pilot Retrospective Chart Review

## TL;DR

This study explores whether type 2 diabetes worsens Alzheimer's disease severity in a predominantly Hispanic population in the Rio Grande Valley.

## Contribution

It is a pilot study focusing on a specific Hispanic community to investigate the link between type 2 diabetes and Alzheimer's severity.

## Key findings

- No significant difference in Global Deterioration Scale scores between Alzheimer's patients with and without type 2 diabetes.
- A trend toward higher severity in Alzheimer's patients with type 2 diabetes was observed, with a medium effect size.
- The study highlights the need for better assessment tools and documentation in small clinics to track Alzheimer's progression.

## Abstract

Background: Alzheimer’s disease (AD) is becoming more prevalent worldwide, leading to a growing demand to understand the impact of risk factors on disease progression. Notably, type 2 diabetes mellitus (DM) has emerged as a significant risk factor for the development of AD, given the pathophysiological role of insulin resistance in cognitive impairment. In particular, the impact of type 2 DM on AD development and severity may be heightened in Hispanic populations due to the high prevalence of both conditions in this community. Here, we sought to understand the role of type 2 DM in AD severity in a Hispanic population from the Rio Grande Valley (RGV), a community wherein 91% of the population identifies as Hispanic.

Methods: We conducted a pilot retrospective chart review from January 2018 to March 2024 at UTHealth RGV for patients with AD who self-identified as Hispanic, Mexican, or Latino. Medical charts were evaluated for a diagnosis of type 2 DM, and demographics were recorded. We categorized the included charts into two groups: AD with DM and AD without DM. For all charts, the Global Deterioration Scale (GDS) score was manually determined from the electronic medical record. T-tests were used to evaluate differences between the two groups.

Results: Forty patients met the inclusion criteria for our study. Eleven medical charts were excluded (72.5% analysis rate) due to insufficient documentation for GDS scoring. No significant differences were found in baseline demographics between the AD with DM and AD without DM groups. GDS scores were not statistically different between groups (p = 0.152), although a medium effect size was observed (d = 0.52, 95% CI (-0.18, 1.23)), with higher GDS scores in the AD with DM group.

Conclusion: Our findings suggest a trend toward more severe AD in Hispanic patients with type 2 DM. Based on these results, we recommend the development of standardized assessment tools for AD, particularly for use in small community clinics, to improve the evaluation of disease progression. Improved clinical documentation and assessment may help identify risk factors that allow for earlier diagnosis or preventive interventions.