Dementia Diagnosis Is Associated with Changes in Antidiabetic Drug Prescription: An Open-Cohort Study of ∼130,000 Swedish Subjects over 14 Years

Sečník, Juraj; Xu, Hong; Schwertner, Emilia; Hammar, Niklas; Alvarsson, Michael; Winblad, Bengt; Eriksdotter, Maria; García-Ptacek, Sara; Religa, Dorota

doi:10.3233/jad-200618

Cited by 13 publications

(25 citation statements)

References 42 publications

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“…Our study suggests that in patients with T2DM who are on SGLT2 inhibitors, the risk of dementia development is 11% lower when compared with the non-users, which may be the possible cause for the increase in its use. 34 These findings signify the need for conducting clinical trials to prove the role of the drug in preventing dementia in the future.…”

Section: Discussionmentioning

confidence: 99%

The association between sodium-glucose cotransporter 2 inhibitors and incident dementia: A nationwide population-based longitudinal cohort study

Siao

Lin

Huang

et al. 2022

Diabetes and Vascular Disease Research

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Background The association of the use of sodium-glucose cotransporter 2 (SGLT2) inhibitor and incident dementia remains unclear. This study aimed to evaluate the risk of incident dementia with the use of SGLT2 inhibitor. Methods This is a population-based cohort study utilizing Taiwan’s National Health Insurance Research Database. Each patient who took SGLT2 inhibitors was assigned to the SGLT2 inhibitor group, whereas 1:1 propensity score-matched randomly selected patients who were nonusers of SGLT2 inhibitors were assigned to the non-SGLT2 inhibitor group. The study outcome was incident dementia. Results A total of 976,972 patients newly diagnosed with type 2 diabetes mellitus (DM) between 2011 and 2018 were included in this study. After the patients’ propensity score matching by age, sex, duration of DM, comorbidities and drug index date of the patients, a total of 103,247 patients in the SGLT2 inhibitor group and 103,247 in the non-SGLT2 inhibitor group were enrolled for analysis. The SGLT2 inhibitor group was associated with a lower risk of incident dementia (adjusted hazard ratio: 0.89, 95% confidence interval: 0.82–0.96; p = .0021). Diabetic complications were significantly lower in the SGLT2 inhibitor group compared with the non-SGLT2 group. Sensitivity analysis was also consistent with the main analysis. Conclusions Patients with type 2 DM who were prescribed SGLT2 inhibitors were associated with a lower risk of incident dementia compared with those not prescribed SGLT2 inhibitors in real-world practice.

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Section: Discussionmentioning

confidence: 99%

The association between sodium-glucose cotransporter 2 inhibitors and incident dementia: A nationwide population-based longitudinal cohort study

Siao

Lin

Huang

et al. 2022

Diabetes and Vascular Disease Research

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“…The percentage of female participants ranged from 47.8% to 79%. Of the included studies, eight were cohort studies, 30‐37 and two were case‐control studies 23,38 . Studies were conducted in Germany ( n = 3), 34,37,38 Sweden ( n = 3), 32,35,36 Italy ( n = 1), 33 Canada ( n = 1), 23 France ( n = 1), 33 the United Kingdom ( n = 1), 30 and the United states of America ( n = 1) 31 .…”

Section: Resultsmentioning

confidence: 99%

Medication use to manage comorbidities in people with dementia: a systematic review

Wang

Alan

Page

et al. 2022

Pharmacy Practice and Res

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Aim To investigate physical health outcomes associated with medications prescribed to manage chronic physical conditions in people living with dementia; and determine whether a dementia diagnosis altered drug utilisation patterns for physical health conditions. Data sources Medline, Embase, Central and Scopus were searched 01/2011 to 12/2020. Study selection Experimental and observational studies, where participants with dementia using medications prescribed by doctors to prevent or treat one or more chronic comorbid physical condition, were compared to no intervention, usual care, or a non‐dementia comparison group. The outcomes of interest were clinically meaningful physical outcomes, and medication utilisation patterns. Results Ten studies met the inclusion criteria. All were of medium to high quality relative to their study design. Mixed findings were reported for ischemic stroke (n = 3), all‐cause mortality (n = 3) and bleeding‐related outcomes (n = 2). This is likely due to the heterogeneity in exposures reported. One study found that people with dementia, receiving antidiabetic management, had a higher rate of severe hypoglycaemia compared to people without dementia. Medication utilisation pattern outcomes included oral anticoagulant use before stroke‐related hospitalisation (n = 1), antithrombotic medication use before stroke‐related hospitalisation (n = 1), cardiovascular medication use for secondary prevention of ischemic heart disease (n = 1), antidepressant medication discontinuation (n = 1), osteoporosis treatment (n = 1), diabetic medication use (n = 2), and antihypertensive medication discontinuation (n = 1). Conclusion This systematic review showed there is currently insufficient evidence to conclude that medication management in people with dementia should differ substantially to people without dementia. Comprehensive and high‐quality evidence is needed to improve confidence that medication prescribing achieves optimum clinical outcomes, quality of life, and benefit‐to‐risk determination in this vulnerable population.

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“…On the other hand, Scenik et al, examined the pharmacological changes in the treatment of diabetes in patients with dementia. They indicated that dementia patients were less likely to receive new diabetes medications and they had higher insulin dispensation ratio than non-dementia controls (Secnik et al, 2020b). Reviewing NACC data showed also that diabetes is associated with accelerated cognitive decline in patients with APOE2 and APOE3 genotypes but not APOE4 carriers (Shinohara et al, 2020).…”

Section: Association Of Dementia With Other Diseasesmentioning

confidence: 99%

The Impact of Disease Registries on Advancing Knowledge and Understanding of Dementia Globally

Heikal

Salama

Richard³

et al. 2022

Front. Aging Neurosci.

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To help address the increasing challenges related to the provision of dementia care, dementia registries have emerged around the world as important tools to gain insights and a better understanding of the disease process. Dementia registries provide a valuable source of standardized data collected from a large number of patients. This review explores the published research relating to different dementia registries around the world and discusses how these registries have improved our knowledge and understanding of the incidence, prevalence, risk factors, mortality, diagnosis, and management of dementia. A number of the best-known dementia registries with high research output including SveDem, NACC, ReDeGi, CREDOS and PRODEM were selected to study the publication output based on their data, investigate the key findings of these registry-based studies. Registries data contributed to understanding many aspects of the disease including disease prevalence in specific areas, patient characteristics and how they differ in populations, mortality risks, as well as the disease risk factors. Registries data impacted the quality of patients’ lives through determining the best treatment strategy for a patient based on previous patient outcomes. In conclusion, registries have significantly advanced scientific knowledge and understanding of dementia and impacted policy, clinical practice care delivery.

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Dementia Diagnosis Is Associated with Changes in Antidiabetic Drug Prescription: An Open-Cohort Study of ∼130,000 Swedish Subjects over 14 Years

Cited by 13 publications

References 42 publications

The association between sodium-glucose cotransporter 2 inhibitors and incident dementia: A nationwide population-based longitudinal cohort study

The association between sodium-glucose cotransporter 2 inhibitors and incident dementia: A nationwide population-based longitudinal cohort study

Medication use to manage comorbidities in people with dementia: a systematic review

The Impact of Disease Registries on Advancing Knowledge and Understanding of Dementia Globally

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