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Clinical Manifestations.

Taiane Santos Garcia1, Sheyla Velasques Paladini1, João Pedro Ferrari-Souza2

  • 1Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Potentially inappropriate medications (PIMs) used by older adults with diabetes may affect cognitive function and Alzheimer's disease (AD) biomarkers. This highlights the need for careful prescribing to avoid misdiagnosis and ensure patient safety.

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Area of Science:

  • Neuroscience
  • Geriatrics
  • Pharmacology

Background:

  • Alzheimer's Disease Neuroimaging Initiative (ADNI) data is used to improve Alzheimer's disease (AD) clinical trials.
  • Patients with diabetes often use potentially inappropriate medications (PIMs) that can impact cognition and AD biomarkers.
  • PIM use in diabetic individuals may confound AD diagnosis.

Purpose of the Study:

  • Investigate the association between PIM use in individuals with diabetes and cognitive changes.
  • Examine the link between PIM use and biomarkers that could be misinterpreted as AD.

Main Methods:

  • Utilized ADNI data including medication history, diabetes status, cognitive performance, and biomarkers (PET/MRI, beta-amyloid, tau).
  • Identified PIMs using the Beers criteria for older adults with diabetes.
  • Analyzed data from individuals with and without AD diagnosis from the ADNI database.

Main Results:

  • The study included 411 individuals (310 with diabetes), with 96 identified as PIM users.
  • Common PIMs included sulfonylureas and short- or rapid-acting insulin.
  • These medications can cause hypoglycemia, leading to confusion, agitation, and cognitive changes in the elderly.

Conclusions:

  • PIMs are commonly used by older adults with diabetes and may influence cognitive outcomes and AD biomarkers.
  • Rational prescribing is crucial for this vulnerable population.
  • This study aids in differential diagnosis and promotes safer pharmacotherapy in older adults with diabetes.