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J Alzheimers Dis. 2018;66(2):725-732. doi: 10.3233/JAD-180808.

Association Between the Use of Antihyperglycemic Drugs and Dementia Risk: A Case-Control Study.

Author information

1
Neuropsychiatric practice, Berlin, Germany.
2
Faculty of Medicine, University of Paris 5, Paris, France.
3
Epidemiology, IQVIA, Frankfurt, Germany.

Abstract

BACKGROUND:

There is a conflicting literature on the association between the use of antihyperglycemic drugs and dementia risk.

OBJECTIVE:

The goal of this case-control study was to analyze the association between the use of antihyperglycemic drugs and dementia risk in patients followed in general practices in Germany.

METHODS:

This study included patients with type 2 diabetes mellitus who had received a first dementia diagnosis in 972 general practices in Germany between January 2013 and December 2017 (index date). Controls without dementia were matched (1:1) to cases by age, gender, index year, and physician. Two multivariate regression models were used to study the association between the use of antihyperglycemic drugs and dementia risk. Model 1 included all antihyperglycemic drugs prescribed to patients regardless of the prescription duration, whereas Model 2 only included the longest therapy prescribed to each patient.

RESULTS:

There were 8,276 diabetes patients with dementia and 8,276 diabetes patients without dementia included in this study. In Model 1, glitazones were associated with a decreased dementia risk (odds ratio [OR] = 0.80), whereas insulin was associated with an increased risk of developing the condition (OR = 1.34). In Model 2, metformin, prescribed as monotherapy (OR = 0.71) or as dual therapy with sulfonylureas (OR = 0.90), was associated with a decrease in the likelihood of subsequently being diagnosed with dementia. By contrast, the combination of basal insulin and bolus insulin (OR = 1.47) and premix insulin (OR = 1.33) were risk factors for dementia.

CONCLUSION:

Metformin and glitazones were negatively associated with dementia, while insulin was positively associated with dementia.

KEYWORDS:

Antihyperglycemic drugs; Germany; case-control study; dementia

PMID:
30320593
DOI:
10.3233/JAD-180808

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