Metformin and Sulfonylurea Use and Risk of Incident Dementia.

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  • Additional Information
    • Source:
      Publisher: [Oxford, England] Country of Publication: England NLM ID: 0405543 Publication Model: Print Cited Medium: Internet ISSN: 1942-5546 (Electronic) Linking ISSN: 00256196 NLM ISO Abbreviation: Mayo Clin Proc Subsets: MEDLINE
    • Publication Information:
      Publication: Jan. 2012- : [Oxford, England] : Elsevier
      Original Publication: Rochester, MN : Mayo Foundation for Medical Education and Research
    • Subject Terms:
      Dementia/*chemically induced ; Dementia/*epidemiology ; Diabetes Mellitus, Type 2/*drug therapy ; Metformin/*adverse effects ; Sulfonylurea Compounds/*adverse effects; Age Factors ; Aged ; Databases, Factual ; Dementia/physiopathology ; Diabetes Mellitus, Type 2/diagnosis ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Female ; Hospitals, Veterans ; Humans ; Incidence ; Male ; Metformin/therapeutic use ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Sex Factors ; Sulfonylurea Compounds/therapeutic use ; United States
    • Abstract:
      Objective: To compare incident dementia risk among patients who initiated treatment with metformin or sulfonylurea in Veterans Health Affairs (VHA) patients with replication in Kaiser Permanente Washington (KPW) patients to determine whether first-choice antidiabetic medications are associated with reduced risk of dementia.
      Patients and Methods: Cohorts contained 75,187 VHA patients and 10,866 KPW patients, 50 years and older, who initiated monotherapy with metformin or sulfonylurea. Patients were free of dementia diagnoses and any diabetes treatment for 2 years before cohort entry. Variables were extracted from electronic health data from VHA (1999-2015) and KPW (1996-2015), which included diagnosis codes, pharmacy data, laboratory values, and demographic characteristics. Propensity scores and inverse probability of treatment weighting controlled for confounding.
      Results: Veterans Health Affairs patients were 60.8±6.8 years of age on average, and KPW patients were 63.1±9.5 years of age. In the VHA sample, 72,769 (96.8%) were male; and in the KPW sample, 5480 (50.4%). After adjusting for confounding, metformin initiation was associated with a significantly (P=.02) lower risk of dementia in VHA (hazard ratio, 0.9; 95% CI, 0.9-1.0), with a similar point estimate in KPW (hazard ratio, 0.9; 95% CI, 0.7-1.1). Metformin was not associated with dementia risk in patients 75 years and older.
      Conclusion: Existing epidemiological studies of metformin and incident dementia have been inconsistent. Using a similar study design in 2 patient populations that differed in clinical and demographic characteristics, our results provide robust evidence that metformin use is associated with a modestly lower risk of incident dementia.
      (Copyright © 2019 Mayo Foundation for Medical Education and Research. All rights reserved.)
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    • Grant Information:
      R21 AG055604 United States AG NIA NIH HHS
    • Accession Number:
      0 (Sulfonylurea Compounds)
      9100L32L2N (Metformin)
    • Publication Date:
      Date Created: 20190806 Date Completed: 20200109 Latest Revision: 20240725
    • Publication Date:
      20240726
    • Accession Number:
      PMC7029783
    • Accession Number:
      10.1016/j.mayocp.2019.01.004
    • Accession Number:
      31378227