Increased Risk of Cognitive Impairment in Patients With Diabetes Is Associated With Metformin
Top Cited Papers
Open Access
- 14 September 2013
- journal article
- Published by American Diabetes Association in Diabetes Care
- Vol. 36 (10), 2981-2987
- https://doi.org/10.2337/dc13-0229
Abstract
OBJECTIVE To investigate the associations of metformin, serum vitamin B12, calcium supplements, and cognitive impairment in patients with diabetes. RESEARCH DESIGN AND METHODS Participants were recruited from the Primary Research in Memory (PRIME) clinics study, the Australian Imaging, Biomarkers and Lifestyle (AIBL) study of aging, and the Barwon region of southeastern Australia. Patients with Alzheimer disease (AD) (n = 480) or mild cognitive impairment (n = 187) and those who were cognitively intact (n = 687) were included; patients with stroke or with neurodegenerative diseases other than AD were excluded. Subgroup analyses were performed for participants who had either type 2 diabetes (n = 104) or impaired glucose tolerance (n = 22). RESULTS Participants with diabetes (n = 126) had worse cognitive performance than participants who did not have diabetes (n = 1,228; adjusted odds ratio 1.51 [95% CI 1.03–2.21]). Among participants with diabetes, worse cognitive performance was associated with metformin use (2.23 [1.05–4.75]). After adjusting for age, sex, level of education, history of depression, serum vitamin B12, and metformin use, participants with diabetes who were taking calcium supplements had better cognitive performance (0.41 [0.19–0.92]). CONCLUSIONS Metformin use was associated with impaired cognitive performance. Vitamin B12 and calcium supplements may alleviate metformin-induced vitamin B12 deficiency and were associated with better cognitive outcomes. Prospective trials are warranted to assess the beneficial effects of vitamin B12 and calcium use on cognition in older people with diabetes who are taking metformin.Keywords
This publication has 41 references indexed in Scilit:
- Metformin attenuates Alzheimer's disease-like neuropathology in obese, leptin-resistant micePharmacology Biochemistry and Behavior, 2012
- Diabetes and Pre-Diabetes as Determined by Glycated Haemoglobin A1c and Glucose Levels in a Developing Southern Chinese PopulationPLOS ONE, 2012
- Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalencePopulation Health Metrics, 2010
- Meta-Analysis of Alzheimer's Disease Risk with Obesity, Diabetes, and Related DisordersBiological Psychiatry, 2010
- Diabetes Is Associated with Increased Rate of Cognitive Decline in Questionably Demented ElderlyDementia and Geriatric Cognitive Disorders, 2010
- Effects of Calcium on Cardiovascular Events in Patients with Kidney Disease and in a Healthy PopulationClinical Journal of the American Society of Nephrology, 2010
- Antidiabetic drug metformin (Glucophage R ) increases biogenesis of Alzheimer's amyloid peptides via up-regulating BACE1 transcriptionProceedings of the National Academy of Sciences of the United States of America, 2009
- Sensitivity of Four Psychometric Tests to Measure Cognitive Changes in Brain Aging-Population-based StudiesAmerican Journal of Epidemiology, 2006
- Role of AMP-activated protein kinase in mechanism of metformin actionJCI Insight, 2001
- UKPDS 50: Risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosisDiabetologia, 2001