Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis

Cheng, Chih‐Tao; Lin, Ching Heng; Tsai, Yi Wen; Tsai, Chia Jui; Chou, Po-Han; Lan, Tsuo Hung

doi:10.1093/gerona/glu073

Cited by 144 publications

(150 citation statements)

References 19 publications

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“…From a retrospective study, hospital-admitted T2DM patients had a relative risk (RR) of 1.37 for dementia compared to controls [4]. By contrast, the RR for dementia diagnosis was 1.56 among newly onset T2DM patients compared to those participants without T2DM [5]. The increased risk for dementia in T2DM patients was associated with many factors (Table 1), including age [6,7], apolipoprotein E (APOE) ε4 carrier status [6], and medications, such as oral hypoglycemic agents and use of statins (lipid metabolism modifying agent) [6].…”

Section: T2dm As a Risk Factor For Dementiamentioning

confidence: 99%

An Update on Type 2 Diabetes Mellitus as a Risk Factor for Dementia

Huang

2016

JAD

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With the rapidly expanding evidence on brain structural and functional changes in type 2 diabetes mellitus (T2DM) patients, there is an increasing need to update our understanding on how T2DM associates with dementia as well as the underlying pathophysiological mechanisms. A literature search of T2DM and dementia or cognition impairments was carried out in electronic databases Medline, EMBASE, and Google Scholar. In this review, the chosen evidence was limited to human subject studies only, and data on either type 1 diabetes mellitus (T1DM) or non-classified diabetes were excluded. T2DM is a risk factor for both vascular dementia (VaD) and Alzheimer's disease (AD), although AD pathological marker studies have not provided sufficient evidence. T2DM interacts additively or synergistically with many factors, including old age, hypertension, total cholesterol, and APOE 4 carrier status for impaired cognition functions seen in patients with T2DM. In addition, comorbid T2DM can worsen the clinical presentations of patients with either AD or VaD. In summary, T2DM increases the risk for AD through different mechanisms for VaD although some mechanisms may overlap. Tau-related neurofibrillary tangles instead of amyloid-␤ plaques are more likely to be the pathological biomarkers for T2DM-related dementia. Degeneration of neurons in the brain, impaired regional blood supply/metabolism, and genetic predisposition are all involved in T2DM-associated dementia or cognitive impairments.

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Section: T2dm As a Risk Factor For Dementiamentioning

confidence: 99%

An Update on Type 2 Diabetes Mellitus as a Risk Factor for Dementia

Huang

2016

JAD

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“…Observational studies show reductions in mild cognitive impairment (MCI) [52] and dementia [53,54] among participants with diabetes taking metformin when compared with no medication or other glucose-lowering agents. For example, a Taiwanese study in individuals aged ≥ 50 years found that metformin use significantly decreased the risk of dementia compared with no medication (HR 0.76 [95% CI 0.58, 0.98]) [51].…”

Section: Clinical Impact Of Metformin Beyond Glycaemic Controlmentioning

confidence: 99%

Metformin and ageing: improving ageing outcomes beyond glycaemic control

et al. 2017

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In a world where the population is ageing, there is growing interest and demand for research evaluating strategies that address the ageing process. After 60 years of successful use of metformin in our pharmaceutical armamentarium, we are learning that, beyond improving glycaemic control, metformin may have additional mechanisms and pathways of action that need further study. Although, metformin’s effect on clinical ageing outcomes may still be considered speculative, the findings from studies into cellular and animal models and from observational and pilot human studies support the existence of beneficial effects on ageing. At present, progress for human research, using randomised clinical trials to evaluate metformin’s clinical impact, has just started. Here, we present a review on the ageing process and the mechanisms involved, and the role that metformin may have to counter these. We go on to discuss the upcoming large randomised clinical trials that may provide insight on the use of metformin for ageing outcomes beyond glycaemic control.

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“…The literature search yielded six qualified studies [18,19,20,21,22,23]. Figure 1 shows the process of studies being included and excluded.…”

Section: Resultsmentioning

confidence: 99%

“…Characteristics of the included studies and comparisons are shown in table 1. In three studies [19,21,23], data of participants treated with monotherapy and combined therapy were both displayed, and as mentioned above, data of the former were adopted. Two studies [18,23] contained both data referenced to PDnD and PnD, and as mentioned above, data of the former were adopted.…”

Section: Resultsmentioning

confidence: 99%

Impact of Insulin Sensitizers on the Incidence of Dementia: A Meta-Analysis

Luo

Xiao

et al. 2016

Dement Geriatr Cogn Disord

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Background: Abundant evidence from epidemiological and clinical studies has proven that diabetes mellitus (DM) is correlated with an increased incidence of dementia and Alzheimer's disease (AD). Insulin resistance is considered to play an important role in the associations between DM and dementia. However, whether insulin sensitizer drugs are effective in preventing dementia still remains unclear. Methods: Electronic searches of PubMed, EMBASE, Google Scholar, and the ISI Web of Science were conducted to identify studies that reported about the associations between insulin sensitizers and the incidence of dementia. The included studies were reviewed, and a meta-analysis was performed using STATA to determine the combined relative risk (RR) for the incidence of dementia when using insulin sensitizers. Subgroup analysis and meta regression were also conducted. Results: In total, nine comparisons out of six studies were qualified for inclusion, and data from 544,093 participants were evaluated. The results of the meta-analysis revealed a combined RR of 0.78 (95% CI 0.64-0.95, p = 0.015) for the incidence of dementia when using insulin sensitizers. The incidence rate of dementia was reduced with either metformin (RR 0.79, 95% CI 0.62-1.01, p = 0.064) or thiazolidinediones (RR 0.75, 95% CI 0.56-1.00, p = 0.050), both with a marginal trend toward significance. Conclusions: The results indicate that insulin sensitizer drugs might provide protection against incident dementia. Controlled studies with large samples should be conducted to further confirm these conclusions and provide information for clinical strategies.

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Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis

Abstract: Diabetes is associated with an increased risk of dementia. The risk effect becomes weaker provided that participants take sulfonylureas or metformin rather than thiazolidinediones for a longer period.

Cited by 144 publications

References 19 publications

An Update on Type 2 Diabetes Mellitus as a Risk Factor for Dementia

An Update on Type 2 Diabetes Mellitus as a Risk Factor for Dementia

Metformin and ageing: improving ageing outcomes beyond glycaemic control

Impact of Insulin Sensitizers on the Incidence of Dementia: A Meta-Analysis

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