Avi Cohen, Stephen Z Levine, Gabriel Vainstein, Michal Schnaider Beeri, Galit Weinstein
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However, information from observational studies exploring the association between new-generation antidiabetic use and dementia risk is limited.</p><p><strong>Objectives: </strong>To examine the association between new-generation antidiabetic medication use and dementia risk.</p><p><strong>Design: </strong>Retrospective cohort study using electronic health records of a large non-profit health maintenance organization.</p><p><strong>Participants: </strong>84,798 dementia-free individuals aged ≥65y with type 2 diabetes.</p><p><strong>Measurements: </strong>Antidiabetic medication exposure was based on purchased prescriptions and was used as a time-varying variable. Exposure periods were defined as periods in which either dipeptidyl peptidase-4 inhibitors (DPP-4i), sodium-glucose cotransporter-2 inhibitors (SGLT-2i), or glucagon-like peptide-1 analogs (GLP-1a) or their combinations were used, otherwise unexposed. Dementia classification was based on the International Classification of Diseases, Ninth Revision codes or antidementia medication prescriptions. Cox regression models were fitted to quantify the association between antidiabetic medication use and incident dementia. Models were adjusted for 13 potential sources of confounding using inverse-probability weighting.</p><p><strong>Results: </strong>Among 84,798 individuals with a mean diabetes onset age of 66.4 ± 7.5 years, the median follow-up for dementia risk was 8.7 years (Q1-Q3: 5.4-12.8). Dementia was diagnosed in 11,642 (13.7%) individuals. New-generation medication use was associated with reduced dementia risk (HR = 0.69; 95% CI, 0.66-0.73) and by drug classes (DPP-4i, HR 0.67 [95% CI 0.63-0.71]; SGLT-2i, 0.63 [95% CI 0.56-0.70], GLP-1a, 0.61 [95% CI 0.54-0.69].</p><p><strong>Conclusions: </strong>The results of this large-scale study suggest that new-generation antidiabetic medication use may be associated with lower dementia risk in older adults with T2D.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100199"},"PeriodicalIF":4.3000,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"New-generation antidiabetic medications and dementia risk in older adults with type 2 diabetes: A retrospective cohort study.\",\"authors\":\"Avi Cohen, Stephen Z Levine, Gabriel Vainstein, Michal Schnaider Beeri, Galit Weinstein\",\"doi\":\"10.1016/j.tjpad.2025.100199\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>New-generation antidiabetic medications may have therapeutic potential for dementia, beyond their glycemic effects. 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引用次数: 0
摘要
背景：新一代抗糖尿病药物可能具有治疗痴呆的潜力，除了它们的降糖作用。然而，从观察性研究中探索新一代抗糖尿病药物使用与痴呆风险之间关系的信息有限。目的：探讨新一代抗糖尿病药物使用与痴呆风险的关系。设计：回顾性队列研究，使用大型非营利性健康维护组织的电子健康记录。参与者：84,798名年龄≥65岁的无痴呆2型糖尿病患者。测量方法：抗糖尿病药物暴露以购买处方为基础，并作为时变变量。暴露期定义为使用二肽基肽酶-4抑制剂（DPP-4i）、钠-葡萄糖共转运蛋白-2抑制剂（SGLT-2i）或胰高血糖素样肽-1类似物（GLP-1a）或它们的组合，否则不暴露。痴呆分类依据《国际疾病分类》第九次修订代码或抗痴呆药物处方。Cox回归模型拟合量化抗糖尿病药物使用与痴呆发生率之间的关系。采用逆概率加权法对模型进行了13个潜在混淆源的调整。结果：在84,798例平均糖尿病发病年龄为66.4±7.5岁的患者中，痴呆风险的中位随访时间为8.7年（Q1-Q3: 5.4-12.8）。11,642人（13.7%）被诊断为痴呆症。新一代药物的使用与痴呆风险降低相关(HR = 0.69；95% CI, 0.66-0.73)和药物类别(DPP-4i, HR 0.67 [95% CI 0.63-0.71]；SGLT-2i, 0.63 (95% CI 0.56 - -0.70), GLP-1a 0.61 (95% CI 0.54 - -0.69)。结论：这项大规模研究的结果表明，新一代抗糖尿病药物的使用可能与老年T2D患者痴呆风险降低有关。
New-generation antidiabetic medications and dementia risk in older adults with type 2 diabetes: A retrospective cohort study.
Background: New-generation antidiabetic medications may have therapeutic potential for dementia, beyond their glycemic effects. However, information from observational studies exploring the association between new-generation antidiabetic use and dementia risk is limited.
Objectives: To examine the association between new-generation antidiabetic medication use and dementia risk.
Design: Retrospective cohort study using electronic health records of a large non-profit health maintenance organization.
Participants: 84,798 dementia-free individuals aged ≥65y with type 2 diabetes.
Measurements: Antidiabetic medication exposure was based on purchased prescriptions and was used as a time-varying variable. Exposure periods were defined as periods in which either dipeptidyl peptidase-4 inhibitors (DPP-4i), sodium-glucose cotransporter-2 inhibitors (SGLT-2i), or glucagon-like peptide-1 analogs (GLP-1a) or their combinations were used, otherwise unexposed. Dementia classification was based on the International Classification of Diseases, Ninth Revision codes or antidementia medication prescriptions. Cox regression models were fitted to quantify the association between antidiabetic medication use and incident dementia. Models were adjusted for 13 potential sources of confounding using inverse-probability weighting.
Results: Among 84,798 individuals with a mean diabetes onset age of 66.4 ± 7.5 years, the median follow-up for dementia risk was 8.7 years (Q1-Q3: 5.4-12.8). Dementia was diagnosed in 11,642 (13.7%) individuals. New-generation medication use was associated with reduced dementia risk (HR = 0.69; 95% CI, 0.66-0.73) and by drug classes (DPP-4i, HR 0.67 [95% CI 0.63-0.71]; SGLT-2i, 0.63 [95% CI 0.56-0.70], GLP-1a, 0.61 [95% CI 0.54-0.69].
Conclusions: The results of this large-scale study suggest that new-generation antidiabetic medication use may be associated with lower dementia risk in older adults with T2D.
期刊介绍：
The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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