Risk of dementia after initiation of sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors in adults aged 40-69 years with type 2 diabetes: population based cohort study
An erratum to this article was published (BMJ, 2 Sep 2024 ↗)
Main finding · New onset dementiaResult — go to the resultHazard ratio 0.65 95% CI 0.58–0.73Authors' conclusion
SGLT-2 inhibitors might prevent dementia, providing greater benefits with longer treatment. As this study was observational and therefore prone to residual confounding and informative censoring, the effect size could have been overestimated. Randomised controlled trials are needed to confirm these findings.
Study context
- Population
- Adults aged 40–69 years with T2D, Korean National Health Insurance Service data, 2013–21110,885 matched pairs
- Exposure
- SGLT2i vs DPP-4i initiation
- Outcome
- New onset dementia
Methodological detailspropensity score matched
- Propensity score matched
Main finding
As reported in the abstract
Hazard ratio
0.65
95% CI 0.58–0.73
By group
SGLT-2 inhibitors
0.22 per 100 person years
DPP-4 inhibitors
0.35 per 100 person years
- People with newly diagnosed dementia
- 1172
Observational data: associations, not effects.
Secondary outcomes
Control outcomes
- HR, genital infections (positive control)
- 2.67 (2.57 to 2.77)
- HR, osteoarthritis related encounters (negative control)
- 0.97 (0.95 to 0.98)
- HR, cataract surgery (negative control)
- 0.92 (0.89 to 0.96)
Dementia, calibrated for residual confounding measured by cataract surgery
- HR for dementia, calibrated
- 0.70 (0.62 to 0.80)
Dementia by treatment duration
- HR of dementia, >2 years of treatment
- 0.57 (0.46 to 0.70) (95% CI)
- HR of dementia, ≤2 years of treatment
- 0.52 (0.41 to 0.66)
- Association greater for >2 years of treatment and persisted across subgroups
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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