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Discontinuation of Metformin Linked to Increased Dementia Risk

28 Oct 2023 • Prior research has found that initiating metformin treatment was associated with a benefit in dementia risk, including a benefit compared with other antidiabetes drugs. But these associations may be confounded by disease severity and prescribing trends.

A recent cohort study explored the potential link between discontinuing metformin treatment, unrelated to kidney dysfunction, and the incidence of dementia in individuals born before 1955 without prior kidney disease diagnoses at metformin initiation. The study utilized data from 1996 to 2020 and involved 12,220 early terminators, those who ceased metformin with normal kidney function, and 29,126 routine metformin users.

  • The results indicated that early terminators had a 21% higher risk of dementia diagnosis compared to routine users. Interestingly, mediation analysis revealed that changes in HbA1c levels and insulin usage did not significantly contribute to this association, suggesting that the increased dementia risk associated with discontinuing metformin may be largely independent of improvements in glucose control or insulin use.

In conclusion, terminating metformin treatment was associated with increased dementia incidence. This finding may have important implications for clinical treatment of adults with diabetes and provides additional evidence that metformin is associated with reduced dementia risk.

Source: JAMA | Read full story

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