scholarly journals Metformin Use Is Associated With Slowed Cognitive Decline and Reduced Incident Dementia in Older Adults With Type 2 Diabetes: The Sydney Memory and Ageing Study

Diabetes Care ◽  
2020 ◽  
Vol 43 (11) ◽  
pp. 2691-2701
Author(s):  
Katherine Samaras ◽  
Steve Makkar ◽  
John D. Crawford ◽  
Nicole A. Kochan ◽  
Wei Wen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Cognitive Decline ◽  
Incident Dementia ◽  
Ageing Study

scholarly journals Comment on Samara et al. Metformin Use Is Associated With Slowed Cognitive Decline and Reduced Incident Dementia in Older Adults With Type 2 Diabetes: The Sydney Memory and Ageing Study. Diabetes Care 2020;43:2691–2701

Diabetes Care ◽  
2021 ◽  
Vol 44 (4) ◽  
pp. e73-e73
Author(s):  
Jorge Rafael Violante-Cumpa ◽  
Luis Alberto Pérez-Arredondo ◽  
José Gerardo González-González ◽  
Leonardo Guadalupe Mancillas-Adame
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Cognitive Decline ◽  
Diabetes Care ◽  
Incident Dementia ◽  
Ageing Study

scholarly journals Metformin-use is associated with slowed cognitive decline and reduced incident dementia in older adults with type 2 diabetes mellitus: the Sydney Memory and Ageing Study

2020 ◽  
Author(s):  
Katherine Samaras ◽  
Steve Makkar ◽  
John D. Crawford ◽  
Nicole A. Kochan ◽  
Wei Wen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Executive Function ◽  
Cognitive Decline ◽  
Dementia Risk ◽  
Incident Dementia ◽  
Ageing Study ◽  
Global Cognition

<b>Objective:</b> Type 2 diabetes mellitus (diabetes) is characterized by accelerated cognitive decline and higher dementia risk. Controversy exists regarding the impact of metformin which is associated with both increased and decreased dementia rates. The objective of this study was to determine the association of metformin-use with incident dementia and cognitive decline over 6 years in diabetes, compared to those not receiving metformin and those without diabetes. <p><b>Research</b> <b>Design and Methods</b>: Prospective observational study of N=1037 non-demented community-dwelling older participants aged 70-90 at baseline (the Sydney Memory and Ageing Study). Exclusion criteria were dementia, major neurological or psychiatric disease or progressive malignancy. Neuropsychological testing measured cognitive function every two years; a battery of tests measured executive function, memory, attention/speed, language and visuospatial function individually and to a construct of global cognition. Incident dementia was ascertained by a multidisciplinary panel. Total brain, hippocampal and parahippocampal volumes were measured by magnetic resonance at baseline and 2 years (n=526). Data were analyzed by linear mixed modeling, including the covariates of age, sex, education, body mass index, heart disease, hypertension, stroke, smoking and apolipoprotein Ee4 carriage. </p> <p><b>Results</b>: Of n=1037, 123 had diabetes; 67 received metformin (DM+MF) and were demographically similar to those not (DM-noMF) and participants without diabetes (no-DM). DM+MF had significantly slower global cognition and executive function decline compared to DM-noM. Incident dementia was significantly higher in DM-noMF compared to DM+MF (OR 5.29, 95%CI 1.17-23.88, p=0.05).</p> <p><b>Conclusions</b>: Older people with diabetes receiving metformin have slower cognitive decline and lower dementia risk. Large randomized studies in people with and without diabetes will determine whether these associations can be attributed to metformin. </p>

scholarly journals Metformin-use is associated with slowed cognitive decline and reduced incident dementia in older adults with type 2 diabetes mellitus: the Sydney Memory and Ageing Study

2020 ◽  
Author(s):  
Katherine Samaras ◽  
Steve Makkar ◽  
John D. Crawford ◽  
Nicole A. Kochan ◽  
Wei Wen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Executive Function ◽  
Cognitive Decline ◽  
Dementia Risk ◽  
Incident Dementia ◽  
Ageing Study ◽  
Global Cognition

<b>Objective:</b> Type 2 diabetes mellitus (diabetes) is characterized by accelerated cognitive decline and higher dementia risk. Controversy exists regarding the impact of metformin which is associated with both increased and decreased dementia rates. The objective of this study was to determine the association of metformin-use with incident dementia and cognitive decline over 6 years in diabetes, compared to those not receiving metformin and those without diabetes. <p><b>Research</b> <b>Design and Methods</b>: Prospective observational study of N=1037 non-demented community-dwelling older participants aged 70-90 at baseline (the Sydney Memory and Ageing Study). Exclusion criteria were dementia, major neurological or psychiatric disease or progressive malignancy. Neuropsychological testing measured cognitive function every two years; a battery of tests measured executive function, memory, attention/speed, language and visuospatial function individually and to a construct of global cognition. Incident dementia was ascertained by a multidisciplinary panel. Total brain, hippocampal and parahippocampal volumes were measured by magnetic resonance at baseline and 2 years (n=526). Data were analyzed by linear mixed modeling, including the covariates of age, sex, education, body mass index, heart disease, hypertension, stroke, smoking and apolipoprotein Ee4 carriage. </p> <p><b>Results</b>: Of n=1037, 123 had diabetes; 67 received metformin (DM+MF) and were demographically similar to those not (DM-noMF) and participants without diabetes (no-DM). DM+MF had significantly slower global cognition and executive function decline compared to DM-noM. Incident dementia was significantly higher in DM-noMF compared to DM+MF (OR 5.29, 95%CI 1.17-23.88, p=0.05).</p> <p><b>Conclusions</b>: Older people with diabetes receiving metformin have slower cognitive decline and lower dementia risk. Large randomized studies in people with and without diabetes will determine whether these associations can be attributed to metformin. </p>

scholarly journals SAT-LB115 Metformin-Use Is Associated With Slowed Cognitive Decline and Reduced Incident Dementia in Older Adults With Type 2 Diabetes Mellitus: The Sydney Memory and Ageing Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Katherine Samaras ◽  
Steve Makkar ◽  
John D Crawford ◽  
Nicole A Kochan ◽  
Wei Wen ◽  
...  
Keyword(s):  
Older Adults ◽  
Heart Disease ◽  
Executive Function ◽  
Older People ◽  
Cognitive Decline ◽  
Community Dwelling ◽  
Incident Dementia ◽  
Ageing Study ◽  
Global Cognition ◽  
Rate Of Decline

Abstract Background Metformin use in diabetes has been associated with both increased and decreased dementia rates in observational studies of people with diabetes. Objective: To examine changes in global cognition and specific cognitive domains over 6 years in older adults with diabetes treated with metformin, compared to other glucose lowering medications, and to people without diabetes. Methods Data were examined from the Sydney Memory and Ageing Study, a prospective observational study of 6 years duration of 1037 non-demented community-dwelling elderly aged 70-90 at baseline, derived from a compulsory electoral roll. Neuropsychological testing was performed every 2 years with domain measures of memory, executive function, language, visuospatial function, attention and processing speed and a composite of global cognition. Data were analysed by linear mixed modelling, including age, sex, education, body mass index, heart disease, diabetes, hypertension, stroke, smoking and apolipoprotein E ε4 carriage as covariates. Results: At baseline, 123 participants had diabetes (DM) with 67 receiving metformin (DM+MF) who were similar in demographics to those not receiving metformin (DM-noMF) and those without diabetes (no-DM). Participants with diabetes had higher BMI, lower HDL- and LDL-cholesterol and more prevalent heart disease, hypertension and smoking, compared to no-DM. Over 6-years, DM+MF participants had significantly slower rates of decline in global cognition and executive function, compared to DM-noMF, adjusted for covariates. The rate of decline for each cognitive domain was similar between DM+MF and controls. No impact was found in analyses examining interactions with sex, ApoEε4 carriage or hyperlipidemia. No difference was found in the rate of decline in brain volumes between the groups over 2 years. Incident dementia was significantly higher in DM-noMF, compared to DM+MF (adjusted OR 5.29 [95% CI 1.17-23.88], p,0.05), whereas risk of incident dementia was similar between DM+MF and participants without diabetes. Conclusions: In older people with diabetes receiving metformin, rates of cognitive decline and dementia were similar to that found in people without diabetes and significantly less than that found in people with diabetes not receiving metformin. Large randomized studies in people with and without diabetes are required to determine whether these associations can be attributed to metformin alone or if other factors explain these observations. Future studies will clarify if this cheap and safe medication can be repurposed for prevention of cognitive decline in older people.

scholarly journals Specific Dimensions of Depression Have Different Associations With Cognitive Decline in Older Adults With Type 2 Diabetes

Diabetes Care ◽  
2021 ◽  
Vol 44 (3) ◽  
pp. 655-662
Author(s):  
Laili Soleimani ◽  
Ramit Ravona-Springer ◽  
Hung-Mo Lin ◽  
Xiaoyu Liu ◽  
Mary Sano ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Cognitive Decline

scholarly journals Specific Dimensions of Depression Have Different Associations With Cognitive Decline in Older Adults With Type 2 Diabetes

2021 ◽  
Author(s):  
Laili Soleimani ◽  
Ramit Ravona-Springer ◽  
Hung-Mo Lin ◽  
Xiaoyu Liu ◽  
Mary Sano ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Executive Functions ◽  
Cognitive Decline ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Random Coefficients ◽  
Neuropsychological Battery ◽  
Five Dimensions

Objective: Depression is highly frequent in older adults with Type 2 Diabetes and is associated with cognitive impairment. Yet, little is known about how various depression dimensions differentially affect cognition. We investigated longitudinal associations of specific depression dimensions with cognitive decline. <p> </p> <p>Research Design and Methods: Participants (N=1002) were from the Israel Diabetes and Cognitive Decline study, 65+ years of age with Type 2 Diabetes, not demented at baseline. Participants underwent comprehensive neuropsychological battery at baseline and every 18 months thereafter including domains of Episodic Memory, Attention/Working Memory, Semantic Categorization/Language, Executive Function and Z scores of each domain were averaged and further normalized to calculate Global Cognition. Depression items from Geriatric Depression Scale- 15 items (GDS-15) was measured at each visit and subcategorized to five dimensions: Dysphoric Mood, Withdrawal Apathy-Vigor (entitled apathy), Anxiety, Hopelessness and Memory complaint. Random coefficients models examined association of depression dimensions with baseline and longitudinal cognitive functioning adjusting for socio-demographics and baseline characteristics, including cardiovascular risk factors, physical activity and use of diabetic medications. </p> <p> </p> <p>Result: In the fully adjusted model, at baseline, all dimensions of depression, except for anxiety, were associated with some aspects of cognition (p-values from .01 to <.001). Longitudinally, greater apathy scores were associated with faster decline in executive functions (p=.004), a results that withstood adjustment for multiple comparisons. Associations of other depression dimensions with cognitive decline were not significant (p>0.01).</p> <p> </p> <p>Conclusion: Apathy was associated with a faster cognitive decline in executive functions. These findings highlight the heterogeneity of depression as a clinical construct rather than a single entity and point to apathy as a specific risk factor for cognitive decline among older adults with Type 2 Diabetes. </p>

Type 2 Diabetes Mellitus and Cognitive Decline in Two Large Cohorts of Community-Dwelling Older Adults

2008 ◽  
Vol 56 (6) ◽  
pp. 1028-1036 ◽  
Author(s):  
Olivia I. Okereke ◽  
Jae H. Kang ◽  
Nancy R. Cook ◽  
J. Michael Gaziano ◽  
JoAnn E. Manson ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Decline ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals Specific Dimensions of Depression Have Different Associations With Cognitive Decline in Older Adults With Type 2 Diabetes

2021 ◽  
Author(s):  
Laili Soleimani ◽  
Ramit Ravona-Springer ◽  
Hung-Mo Lin ◽  
Xiaoyu Liu ◽  
Mary Sano ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Executive Functions ◽  
Cognitive Decline ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Random Coefficients ◽  
Neuropsychological Battery ◽  
Five Dimensions

Objective: Depression is highly frequent in older adults with Type 2 Diabetes and is associated with cognitive impairment. Yet, little is known about how various depression dimensions differentially affect cognition. We investigated longitudinal associations of specific depression dimensions with cognitive decline. <p> </p> <p>Research Design and Methods: Participants (N=1002) were from the Israel Diabetes and Cognitive Decline study, 65+ years of age with Type 2 Diabetes, not demented at baseline. Participants underwent comprehensive neuropsychological battery at baseline and every 18 months thereafter including domains of Episodic Memory, Attention/Working Memory, Semantic Categorization/Language, Executive Function and Z scores of each domain were averaged and further normalized to calculate Global Cognition. Depression items from Geriatric Depression Scale- 15 items (GDS-15) was measured at each visit and subcategorized to five dimensions: Dysphoric Mood, Withdrawal Apathy-Vigor (entitled apathy), Anxiety, Hopelessness and Memory complaint. Random coefficients models examined association of depression dimensions with baseline and longitudinal cognitive functioning adjusting for socio-demographics and baseline characteristics, including cardiovascular risk factors, physical activity and use of diabetic medications. </p> <p> </p> <p>Result: In the fully adjusted model, at baseline, all dimensions of depression, except for anxiety, were associated with some aspects of cognition (p-values from .01 to <.001). Longitudinally, greater apathy scores were associated with faster decline in executive functions (p=.004), a results that withstood adjustment for multiple comparisons. Associations of other depression dimensions with cognitive decline were not significant (p>0.01).</p> <p> </p> <p>Conclusion: Apathy was associated with a faster cognitive decline in executive functions. These findings highlight the heterogeneity of depression as a clinical construct rather than a single entity and point to apathy as a specific risk factor for cognitive decline among older adults with Type 2 Diabetes. </p>

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