WEDNESDAY, Sept. 23, 2020 — For older adults with type 2 diabetes, cognitive decline is slower and dementia risk reduced for those receiving metformin, according to a study published online Sept. 23 in Diabetes Care.

Katherine Samaras, M.B.B.S., Ph.D., from the Garvan Institute of Medical Research in Darlinghurst, Australia, and colleagues conducted a prospective observational study of 1,037 community-dwelling older adults without dementia aged 70 to 90 years at baseline. Cognitive function was measured every two years, and a battery of tests measured executive function, memory, attention/speed, language, and visuospatial function. At baseline and two years, 526 participants underwent magnetic resonance imaging to measure total brain, hippocampal, and parahippocampal volumes.

The researchers found that 123 of the participants had diabetes and 67 of them received metformin. Compared with those with diabetes who were not receiving metformin, those receiving metformin had significantly slower global cognition and executive functional decline. Compared with those with diabetes receiving metformin, those with diabetes not receiving metformin had significantly higher incident dementia (odds ratio, 5.29).

“Randomized controlled studies are required to determine whether metformin may have a protective effect against dementia or cognitive decline, both in people with diabetes, and given metformin’s long safety record, older people without diabetes,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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