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Long-term metformin usage and cognitive function among older adults with diabetes
Tze Pin Ng1, Liang Feng1, Keng Bee Yap2
1Gerontology Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Journal of Alzheimer'S Disease : JAD
|March 1, 2014
Summary
Long-term metformin use in individuals with diabetes may significantly reduce the risk of cognitive decline and dementia. This insulin-sensitizing medication shows a protective effect, particularly with use exceeding six years.
Area of Science:
- Gerontology
- Neuroscience
- Endocrinology
Background:
- Insulin resistance is strongly linked to cognitive decline and dementia.
- Insulin sensitizers may offer protection against cognitive impairment in diabetic and pre-diabetic individuals.
- Previous studies on rosiglitazone yielded inconclusive results, while metformin's cognitive benefits remained largely unreported.
Purpose of the Study:
- To investigate the association between metformin use and cognitive impairment in older adults with diabetes.
- To evaluate the impact of metformin use duration on cognitive function.
- To explore potential protective effects of metformin against cognitive decline in a population-based cohort.
Main Methods:
- A population-based study of 365 older adults (≥55 years) with diabetes from the Singapore Longitudinal Aging Study.
- Follow-up over 4 years, assessing cognitive impairment using the Mini-Mental State Exam (≤23).
- Cross-sectional and longitudinal multivariate analyses evaluated metformin use (n=204) versus non-use (n=161), considering durations up to 6 years and over 6 years.
Main Results:
- Metformin use was significantly inversely associated with cognitive impairment in longitudinal analysis (OR=0.49).
- Significant linear trends showed reduced cognitive impairment risk with increased metformin use duration.
- Long-term metformin use (over 6 years) was significantly associated with the lowest risk of cognitive impairment (cross-sectional OR=0.30, longitudinal OR=0.27).
Conclusions:
- Long-term treatment with metformin may reduce the risk of cognitive decline in individuals with diabetes.
- The duration of metformin use appears crucial for its cognitive protective effects.
- Further research is needed to elucidate the roles of hyperglycemia, insulin resistance, and metformin in dementia risk.
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