The Correlation between Metformin Use and Incident Dementia in Patients with New-Onset Diabetes Mellitus: A Population-Based Study

Author:

Huang Kuang-Hua1ORCID,Tsai Ya-Fang2ORCID,Lee Chiachi Bonnie1ORCID,Gau Shuo-Yan3ORCID,Tsai Tung-Han1,Chung Ning-Jen3,Lee Chien-Ying45ORCID

Affiliation:

1. Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan

2. Department of Health Policy and Management, Chung Shan Medical University, Taichung 40201, Taiwan

3. School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan

4. Department of Pharmacology, Chung Shan Medical University, Taichung 40201, Taiwan

5. Department of Pharmacy, Chung Shan Medical University Hospital, Taichung 40201, Taiwan

Abstract

The evidence of metformin’s effect on dementia is conflicting. This study investigates the association between metformin use and the risk of dementia among patients with diabetes mellitus (DM). This study included patients with new-onset DM between 2002 and 2013. We divided the patients into patients who used metformin and patients who did not. Two models were used to assess metformin use: the cumulative defined daily dose (cDDD) of metformin use and the intensity of metformin use. This study with 3-year and 5-year follow-ups investigated the risk of dementia among patients with DM who used metformin. At the 3-year follow-up, patients who received cDDD < 300 had an odds ratio (OR) of developing dementia of 0.92 (95% confidence interval [CI] = 0.89–0.96); patients who used metformin at intensities <10 and 10–25 DDD/month had ORs of 0.92 (95% CI: 0.87–0.97) and 0.92 (95% CI: 0.85–1.00), respectively. Metformin use at cDDD 300–500 (OR = 0.80, 95% CI = 0.56–1.15) or >500 (OR = 1.48, 95% CI = 0.48–4.60) or at an intensity >25 DDD/month (OR = 0.84, 95% CI = 0.60–1.18) were not associated with an incident of dementia. There were similar results at the 5-year follow-up. Patients with a low intensity of metformin use had a lower risk of dementia. However, higher doses of metformin with higher intensity exhibited no protective role in dementia. Prospective clinical trials are warranted to evaluate the actual underlying mechanisms between metformin dosage and the risk of dementia.

Funder

Ministry of Science and Technology Taiwan

China Medical University Taiwan

Chung Shan Medical University Hospital, Taiwan

Publisher

MDPI AG

Subject

Medicine (miscellaneous)

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