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Metformin and Cognitive Performance in Patients With Type 2 Diabetes: An Umbrella Review
Athena Enderami1, Behnam Shariati2, Mehran Zarghami3
1Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Neuropsychopharmacology Reports
|January 28, 2025
Summary
Metformin may offer cognitive benefits for type 2 diabetes patients, potentially improving memory and reducing neurodegenerative disease risk. However, current evidence quality is low, necessitating further research on its cognitive effects.
Area of Science:
- Endocrinology
- Neurology
- Pharmacology
Background:
- Contradictory findings exist regarding metformin's impact on cognitive function in type 2 diabetes mellitus (T2DM).
- Metformin is a widely used medication for T2DM management.
- Understanding its neurological effects is crucial for patient care.
Purpose of the Study:
- To systematically review and meta-analyze existing evidence on metformin's role in cognitive performance in T2DM patients.
- To assess the quality of the available evidence.
- To determine potential benefits or risks of metformin on cognition.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (PubMed, Web of Science, Scopus, Cochrane Library, Trip, Google Scholar) up to May 1, 2023.
- Included were English-written systematic reviews and meta-analyses.
- Ten relevant studies were identified from 2672 initial records.
Main Results:
- Evidence suggests metformin may offer cognitive benefits, including potential memory improvements and reduced risk of neurodegenerative diseases.
- Improvements in Mini-Mental State Examination (MMSE) and Selective Reminding Test (SRT) scores were noted.
- Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) alterations raised some concerns, indicating differential impacts on cognitive domains.
Conclusions:
- Metformin might positively influence specific cognitive functions in T2DM patients.
- The current evidence base is characterized by inconsistency and low quality.
- Further high-quality research is required to clarify metformin's precise role (protective, neutral, or context-dependent) in T2DM-related cognitive changes.
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