Oral diabetes medication and risk of dementia in elderly patients with type 2 diabetes

Abstract

Aim: To examine the effect of oral diabetes medication on the risk of dementia in an elderly cohort with type 2 diabetes.

Methods: This was a population-based cohort study using the Korean National Health Insurance claims data from 2002 to 2013. Elderly subjects (60 years of age or older) with and without type 2 diabetes were included; patients with new-onset type 2 diabetes were further divided into the oral diabetes medication group and no-medication group.

Results: Among 278,290 patients with type 2 diabetes, 56,587 developed dementia (20.3%) over 11 years of follow-up. Type 2 diabetes was associated with a 1.69-fold increased risk of dementia (95% CI 1.66-1.72). Among patients with newly diagnosed type 2 diabetes, the risk of dementia was lower in the oral diabetes medication group than in the no-medication group (adjusted hazard ratio [aHR], 0.79; 95% CI 0.77-0.81). Lower risk of dementia was particularly noticeable in all of the combination therapy groups and especially lower in the combination therapy group treated with dipeptidyl peptidase 4 inhibitor (aHR 0.48, 95% CI 0.45-0.51).

Conclusion: Overall, the use of oral diabetes medication in type 2 diabetes patients significantly decreased the risk of dementia.

Keywords: Dementia; Dipeptidyl peptidase 4 inhibitor; Metformin; Sulfonylurea; Thiazolidinedione; Type 2 diabetes mellitus.