The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2019.
PHILADELPHIA — Older men with type 2 diabetes (T2D) who received metformin or a newer hypoglycemic medication had less cognitive decline compared with those who received sulfonylureas, according to study results presented at the American Academy of Neurology annual meeting, held May 4 to 10, 2019, in Philadelphia, Pennsylvania.
Research has shown that biguanides and sulfonylureas may slow or prevent dementia or cognitive decline in patients with diabetes. To assess whether newer antidiabetic medications have the same effect, investigators analyzed 10-year changes in Modified Mini-Mental State Examination score and Trail Making B performance in community-based older men who received monotherapy for T2D (metformin, sulfonylurea, or other hypoglycemic agent). Patients who had severe renal disease, liver disease, or dementia were excluded.
Of 442 men (mean age, 75.3 years), 39.4% received metformin, 50.5% received a sulfonylurea, and 10.2% received another oral agent. At baseline, patients receiving sulfonylureas had worse completion time in the Trail Making evaluation compared with those who received metformin (+15.62 s; P =.006) and newer oral T2D medications (+21.32 s; P =.035).
After 10 years of follow-up and adjusting for age, race, education, body mass index, renal function, and hypertension, the researchers found that patients receiving newer oral antidiabetic medications had significantly less decline in performances on both the Modified Mini-Mental State Examination (mean difference, 5.54 points; P =.017) and the Trails B test (+28.47 s; P =.012) compared with those who received sulfonylureas. In a similar fashion, patients receiving metformin had better Trails B performance compared with those who received sulfonylureas (+22.84 s; P =.043)
“These findings support the possible protective effects of metformin and suggest that newer oral agents may present new opportunities for further research and therapeutic strategies in the prevention of cognitive decline among older adults with diabetes,” concluded the researchers.
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Duarte S, Vittinghoff E, Barret-Connor E, Yaffe K. Metformin and newer oral hypoglycemic agents are associated with better cognitive test performance over ten years in older diabetic men. Presented at: American Academy of Neurology 2019 Annual Meeting; May 4-10, 2019; Philadelphia, PA.