Protective effect of metformin against dementia in patients with obesity: Results from a global federated health network analysis
Authors' conclusion
In this large, multi-centre cohort study, metformin use was associated with reduced risks of dementia and all-cause mortality in obese patients. The protective effect was observed across all BMI groups, with variations noted by population. These findings support the potential of metformin in lowering dementia risk in patients with obesity. Further studies are needed to explore the underlying mechanisms.
Study context
- Population
- Patients with obesity/overweight in 4 body mass index (BMI) groups (25–29.9, 30–34.9, 35–39.9, over 40), TriNetX networkmatched cohorts per BMI group
- Exposure
- Metformin vs no metformin, by BMI group
- Outcome
- Dementia incidence and all-cause mortality
- Follow-up
- 10-year follow-up
Methodological detailspropensity score matching, multi-centre, federated electronic health record network (TriNetX)
- Propensity score matching
- Multi-centre
- Federated electronic health record network (TriNetX)
Main finding
As reported in the abstract
Dementia · 10 years
Metformin vs ControlsHazard ratio (95% CI)
BMI 25-29.9 (n = 132 920)
0.875(0.848–0.904)
BMI 30-34.9 (n = 142 723)
0.917(0.885–0.951)
BMI 35-39.9 (n = 94 402)
0.878(0.834–0.924)
BMI over 40 (n = 82 732)
0.891(0.834–0.953)
Observational data: associations, not effects.
Further findings
All-cause mortality · 10 years
- HR, BMI 25-29.9
- 0.719 (0.701-0.737)
- HR, BMI 30-34.9
- 0.727 (0.708-0.746)
- HR, BMI 35-39.9
- 0.717 (0.694-0.741)
- HR, BMI over 40
- 0.743 (0.717-0.771)
- Significantly lower all-cause mortality risk with metformin vs controls
- Propensity score matched
Original publication
Protective effect of metformin against dementia in patients with obesity: Results from a global federated health network analysis. Diabetes Obes Metab. Published 6 August 2025. doi:10.
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