Heterogeneous treatment effects of metformin on risk of dementia in patients with type 2 diabetes: A longitudinal observational study.

Little is known about the heterogeneous treatment effects of metformin on dementia risk in people with type 2 diabetes (T2D). Participants (≥ 50 years) with T2D and normal cognition at baseline were identified from the National Alzheimer's Coordinating Center database (2005-2021). We applied a doubly robust learning approach to estimate risk differences (RD) with a 95% confidence interval (CI) for dementia risk between metformin use and no use in the overall population and subgroups identified through a decision tree model. Among 1393 participants, 104 developed dementia over a 4-year median follow-up. Metformin was significantly associated with a lower risk of dementia in the overall population (RD, -3.2%; 95% CI, -6.2% to -0.2%). We identified four subgroups with varied risks for dementia, defined by neuropsychiatric disorders, non-steroidal anti-inflammatory drugs, and antidepressant use. Metformin use was significantly associated with a lower risk of dementia in individuals with T2D, with significant variability among subgroups. © 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

Citation

Huilin Tang, Jingchuan Guo, C Elizabeth Shaaban, Zheng Feng, Yonghui Wu, Tanja Magoc, Xia Hu, William T Donahoo, Steven T DeKosky, Jiang Bian. Heterogeneous treatment effects of metformin on risk of dementia in patients with type 2 diabetes: A longitudinal observational study. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2024 Feb;20(2):975-985

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PMID: 37830443

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