The prevalence of Alzheimer’s disease among diabetic patients in Saudi Arabia

Alhanouf S. Alqudah; Nahed S. Abaalkhail; Alanoud S. Alturki; Yasmen S. Naseer; Sara K. Almansour

doi:10.15537/smj.2025.46.3.20240778

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Table 1

- Demographic data of study participants in Riyadh, Saudi Arabia (N=228).

Variables	n (%)
Gender
Male	99 (43.4)
Female	129 (56.6)
Age (years), mean±SD	48.9±22.4
Educational level
Below high school	94 (41.2)
College/university education	130 (57.0)
Graduate/postgraduate education	4 (1.8)
Family history of Alzheimer’s disease
Yes	39 (17.1)
No	136 (59.6)
Unknown	53 (23.3)
Type of diabetes
T1DM	106 (46.5)
T2DM	115 (50.4)
Pre-diabetes	7 (3.1)
Duration of diabetes (year)
<5 years	70 (30.7)
5-10	64 (28.1)
11-20	58 (25.4)
>20 years	36 (15.8)
Other comorbidity
Cardiovascular disease	85 (29.8)
Blood pressure hypertension	100 (48.9)
Obesity	34 (15.3)
Other	9 (6.0)
Smoking habit*
Smokers	23 (10.0)
Non-smokers	193 (85.0)
Occupation*
Not working/retired	107 (46.9)
Housewife	32 (14.0)
Student	26 (11.4)
Administrator employee	30 (13.2)
Other	17 (7.4)
Source of Alzheimer’s’ knowledge
Health practitioner	146 (64.0)
Family and friends	35 (15.4)
Social media	43 (18.9)
Other	4 (1.7)

Values are presented as numbers and percentages (%).

↵* Missing data. SD: standard deviation, T1DM: type 1 diabetes, T2DM: type 2 diabetes

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Table 2

- Public knowledge and awareness regarding Alzheimer’s disease in Saudi Arabia, among diabetics (N=228).

Questions included in each subdomain	Agree	Disagree
Life impact
People with AD are particularly prone to depression.	165 (72.0)	63 (28.0)
It is safe for people with AD to drive as long as they have a companion in the car at all times.
Most people with AD live in nursing homes.
Risk Factors
Prescription drugs that prevent AD are available.	170 (75.0)	58 (25.0)
It has been scientifically proven that mental exercises can prevent a person from getting AD.
Genes can only partially account for the development of AD.
Having high cholesterol may increase a person’s risk of developing AD.
Having high blood pressure may increase a person’s risk of developing AD.
People in their 30s can have AD.
Course
Eventually, a person with AD will need 24-hour supervision.	170 (75.0)	58 (25.0)
In rare cases, people have recovered from AD.	170 (75.0)	58 (25.0)
Assessment and diagnosis
AD is one type of dementia.	170 (75.0)	58 (25.0)
Symptoms of severe depression can be mistaken for symptoms of AD.
When a person with AD becomes agitated, a medical examination might reveal other health problems that caused the agitation.
If trouble with memory and confused thinking appears suddenly, it is likely due to AD.
Treatment and management
Poor nutrition can make the symptoms of AD worse.	158 (69.0)	70 (31.0)
AD cannot be cured.	158 (69.0)	70 (31.0)
Symptoms
Trouble handling money or paying bills is a common early symptom of AD.	162 (71.0)	66 (29.0)
A symptom that can occur with AD is believing that other people are stealing one’s things.
Most people with AD remember recent events better than things that happened in the past.
Tremor or shaking of the hands or arms is a common symptom in people with AD
Caregiving
Once people have AD, they are no longer capable of making informed decisions regarding their own care.	165 (72.0)	63 (28.0)
When a person has AD, using reminder notes is a crutch that can contribute to the decline.
When people with AD repeat the same question or story several times, it is helpful to remind them that they are repeating themselves.
People with AD do best with simple instructions given one step at a time.

Values are presented as numbers and percentages (%). AD: Alzheimer disease

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Table 3

- Respondents’ answers to questions “do you think that a healthy diet and follow-up with a nutritionist can improve or alleviate the symptoms associated with Alzheimer’s?”.

Respondents’ answers	Crosstabulation of the question with respondents’ levels of education
Respondents’ answers	Below high school	College/university education	Graduate/postgraduate education	Total	P-value
Yes	73 (32.0)	53 (23.0)	3 (1.0)	129 (57.0)	0.049*
No	33 (14.0)	21 (9.0)	0 (0.0)	54 (24.0)
I don’t know	24 (11.0)	20 (9.0)	1 (1.0)	45 (20.0)
Total	130 (57.0)	94 (41.0)	4 (2.0)	228 (100)

Values are presented as numbers and percentages (%).

* Significant p-value of <0.05.

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Table 4

- Comparison of demographic data with Alzheimer’s disease knowledge scale questionnaires rate among participants who answered the item correctly.

ADKS subdomains	Life impact	Risk factors	Course	Assessment & diagnosis	Treatment & management	Symptoms	Caregiving	P-values
Participants who answered subdomain correctly	165 (72.0)	170 (75.0)	170 (75.0)	170 (75.0)	158 (69.0)	162 (71.0)	165 (72.0)	0.043*
Gender
Male	65 (29.0)	85 (37.0)	87 (38.0)	66 (29.0)	66 (29.0)	65 (29.0)	71 (31.0)	0.052
Female	100 (44.0)	85 (37.0)	83 (17.0)	104 (46.0)	92 (40.0)	97 (43.0)	94 (41.0)	0.052
Age (year), mean±SD	48.23±20.11	47.05±18.94	48.43±19.91	45.03±62.11	47.01±14.50	45.76±84.10	47.10±9.30	0.067
Educational Level
High school and below	36 (16.0)	36 (16.0)	37 (16.0)	36 (16.0)	34 (15.0)	40 (18.0)	31 (14.0)	0.051
Collage education	125 (55.0)	130 (57.0)	130 (57.0)	125 (55.0)	121 (53.0)	119 (52.0)	130 (57.0)
Post graduate education	4 (2.0)	4 (2.0)	3 (1.0)	4 (2.0)	3 (1.0)	3 (1.0)	4 (2.0)
Family history of Alzheimer’s disease
Yes	35 (15.0)	25 (11.0)	25 (11.0)	30 (13.0)	8 (4.0)	24 (11.0)	0 (0.0)	0.070
No	90 (39.0)	100 (44.0)	100 (44.0)	105 (46.0)	150 (66.0)	134 (59.0)	165 (72.0)
Unknown	40 (18.0)	45 (20.0)	45 (20.0)	35 (15.0)	0 (0.0)	4 (2.0)	0 (0.0)
Type of diabetes
T1DM	48 (21.0)	69 (30.0)	66 (29.0)	66 (29.0)	55 (24.0)	50 (22.0)	53 (23.0)	0.065
T2DM	115 (50.0)	101 (44.0)	100 (44.0)	100 (44.0)	98 (43.0)	112 (49.0)	112 (49.0)
Pre-diabetic	2 (1.0)	-	4 (2.0)	4 (2.0)	5 (2.0)	0 (0.0)	0 (0.0)
Duration of diabetes (year)
<5 years	38 (17.0)	40 (18.0)	38 (17.0)	40 (18.0)	33 (14.0)	37 (16.0)	50 (22.0)	0.077
5-10	60 (26.0)	63 (28.0)	63 (28.0)	63 (28.0)	61 (27.0)	60 (26.0)	60 (26.0)
11-20	50 (22.0)	45 (20.0)	45 (20.0)	45 (20.0)	35 (15.0)	40 (18.0)	42 (18.0)
>20 years	17 (7.0)	22 (9.0)	24 (10.0)	22 (9.0)	29 (13.0)	25 (11.0)	13 (6.0)
Comorbidity
Cardiovascular disease	47 (21.0)	50 (22.0)	48 (21.0)	53 (23.0)	36 (16.0)	52 (23.0)	49 (21.0)	0.061
HBP	98 (43.0)	100 (44.0)	100 (44.0)	100 (44.0)	89 (39.0)	85 (37.0)	86 (38.0)
Obesity	20 (9.0)	18 (8.0)	20 (9.0)	11 (5.0)	33 (14.0)	25 (11.0)	30 (13.0)
Other	0 (0.0)	2 (1.0)	4 (2.0)	6 (3.0)	0 (0.0)	0 (0.0)	0 (0.0)
Smoking habit
Smoker	162 (71.0)	168 (74.0)	170 (75.0)	170 (75.0)	154 (68.0)	158 (69.0)	162 (71.0)	0.069
non-smoker	3 (1.0)	2 (1.0)	0 (0.0)	0 (0.0)	4 (2.0)	4 (2.0)	3 (1.0)	0.069
Occupation
Not working/retired	99 (43.0)	100 (44.0)	100 (44.0)	104 (47.0)	85 (37.0)	95 (42.0)	99 (43.0)	0.084
Housewife	20 (9.0)	32 (14.0)	30 (13.0)	30 (13.0)	25 (11.0)	29 (13.0)	29 (13.0)
Student	15 (7.0)	10 (4.0)	11 (5.0)	10 (4.0)	19 (8.0)	11 (5.0)	12 (5.0)
Administrator employee	28 (12.0)	26 (12.0)	27 (12.0)	25 (11.0)	22 (10.0)	20 (9.0)	19 (8.0)
Other	3 (1.0)	2 (1.0)	2 (1.0)	1 (0.8)	7 (3.0)	7 (3.0)	6 (3.0)
The source of Alzheimer knowledge
Health practitioner	130 (57.0)	121 (53.0)	126 (55.0)	126 (55.0)	119 (51.0)	115 (50.0)	120 (53.0)	0.05*
Family and friends	10 (4.0)	20 (9.0)	22 (10.0)	22 (10.0)	15 (7.0)	19 (8.0)	21 (9.0)
Social media	25 (11.0)	27 (12.0)	20 (9.0)	20 (9.0)	22 (10.0)	25 (12.0)	21 (9.0)
Other	0 (0.0)	2 (1.0)	2 (1.0)	2 (1.0)	2 (1.0)	3 (1.0)	3 (1.0)

Values are presented as numbers and percentages (%).

↵* Significant p-value of <0.05. ADKS: Alzheimer’s disease knowledge scale, SD: standard deviation, T1DM: type 1 diabetes, T2DM: type 2 diabetes, HBP: high blood pressure

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Table 5
- Overall p-values for each subdomain and regarding of the result of each question on these subdomain.
Subdomains P-values
Life impact 0.033*^†
Risk factor 0.015*^†
Course 0.667^‡
Assessment and diagnosis 0.521^†
Treatment and management 0.024*^‡
Symptoms 0.386^†
Caregiving 0.011*^†
↵* Significant p-value of <0.05.
↵^† ANOVA test.
↵^‡ T-test.