In a study from the University of Arizona and elsewhere, scientists found the use of an older class of type 2 diabetes drugs called glitazones, also known as thiazolidinediones or TZDs for short, is linked to a 22% reduced risk of dementia.
These drugs may effectively prevent dementia in patients at high risk with mild or moderate type 2 diabetes, and may now be worth prioritizing in future clinical studies to see if they can be repurposed.
Type 2 diabetes and dementia share some of the same physiological patterns, researchers have started to look at whether diabetes drugs might also help stave off or treat dementia.
In the current study, the team compared dementia risk in older people with type 2 diabetes and treated with either a sulfonylurea or a thiazolidinedione (TZD) with those treated with metformin alone.
They used the electronic health records of 559,106 people diagnosed with type 2 diabetes from the national Veteran Affairs (VA) Health System, spanning the period from January 2000 to December 2019.
Only older patients (aged at least 60) and given a first prescription of metformin, or a sulfonylurea (tolbutamide, glimepiride, glipizide, or glyburide), or a TZD (rosiglitazone or pioglitazone) between January 2001 and December 2017 were included (559,106) in the study.
Their health was tracked for an average of nearly 8 years.
The team found after at least one year of drug treatment, the use of a TZD alone was linked to a 22% lower risk of dementia from any cause, compared with the use of metformin alone.
Specifically, it was associated with an 11% lower risk of Alzheimer’s disease and a 57% lower risk of vascular dementia.
Given that vascular diseases increase the risk of Alzheimer’s disease, TZDs may also help to reduce dementia and Alzheimer’s disease in part through their favorable effects on the vascular system.
While the risk of dementia from any cause was 11% lower for the use of metformin and TZD combined, it was 12% higher for the use of a sulfonylurea drug alone, prompting the researchers to suggest that supplementing a sulfonylurea with either metformin or a TZD may partially offset these effects.
The team also found that those younger than 75 benefited more from a TZD than older patients, highlighting the importance of early prevention for dementia.
These drugs also seemed to be more protective in overweight or obese patients.
The team researchers suggest that future studies for repurposing diabetes drugs for dementia prevention might want to consider prioritizing TZDs, based on their findings.
If you care about dementia, please read studies about how the Mediterranean diet could protect your brain health, and Vitamin B supplements could help reduce dementia risk.
For more information about brain health, please see recent studies that cranberries could help boost memory, and how alcohol, coffee, and tea intake influence cognitive decline.
The study was conducted by Xin Tang et al and published in BMJ Open Diabetes Research & Care.
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