Incident dementia risk among patients with type 2 diabetes receiving metformin versus alternative oral glucose-lowering therapy: an observational cohort study using UK primary healthcare records
Main finding · DementiaResult — go to the resultAdjusted hazard ratio 0.86 95% CI 0.79–0.94Authors' conclusion
Metformin use was associated with lower risks of incident dementia and MCI compared with alternative GLT among UK adults with diabetes. While our findings are consistent with a neuroprotective effect of metformin against dementia, further research is needed to reduce risks of confounding by indication and assess causality.
Study context
- Population
- UK adults diagnosed with diabetes at ≥40 years between 1990 and 2019, Clinical Practice Research Datalink; median age 63 years, 42.8% female
- Participants
- 211,396 adults
- Exposure
- Metformin vs alternative oral GLT
- Metforminn = 179,333
- Outcome
- Incident all-cause dementia or mild cognitive impairment (MCI)
- Follow-up
- Median 5.4 years
Methodological detailsactive comparator new user design, Cox proportional hazards regression
- Active comparator new user design
- Cox proportional hazards regression
Main finding
Dementia
Adjusted hazard ratio
0.86
95% CI 0.79–0.94
Metforminvs Alternative oral GLT
aHR 0.86 (95% CI 0.79–0.94)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| MCI · median follow-up 5.4 years | 0.92 (0.86–0.99) | |
| Dementia, age <80 years | 0.77 (0.68–0.85) | |
| Dementia, age ≥80 years | 0.95 (0.87–1.05) | |
| 0.512Adjusted hazard ratio (log scale) |
Interaction with sex
- No interaction with sex
Dementia, as-treated sensitivity analysis
- As-treated analysis: reduced effect size vs main analysis, aHR
- 0.90 (95% CI 0.83 to 0.98)
Original publication
Incident dementia risk among patients with type 2 diabetes receiving metformin versus alternative oral glucose-lowering therapy: an observational cohort study using UK primary healthcare records. BMJ Open Diabetes Res Care. Published 25 January 2024. doi:10.
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