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Title: Metformin and risk of dementia incidence among 0.2 million diabetes patients: an EHR-based cohort study Authors:  Bang Zheng - Imperial College London (United Kingdom) [presenting]
Bowen Su - Imperial College London (United Kingdom)
Abstract: Type 2 diabetes and associated insulin resistance are established risk factors for dementia, a multifactorial neurodegenerative disorder, hence implying a real potential of repurposing anti-diabetes drugs for dementia prevention. We evaluated the association of metformin versus sulfonylureas prescription with the risk of dementia incidence among diabetes patients aged over 50 years, leveraging the UK Clinical Practice Research Datalink (CPRD) from 1987 to 2018. Conventional Cox regression and Propensity Score Weighting analysis were used to estimate hazard ratios (HR) and 95\% confidence intervals (CI). During a median of seven years follow-up, 15,089 incident dementia cases were identified among 187,613 metformin and sulfonylureas initiators. Results from both Conventional Cox regression and Propensity Score Weighting analysis showed that metformin initiators had a lower risk of dementia compared with sulfonylureas initiators (HR= 0.91 (95\% CI: 0.87-0.95) and 0.88 (95\% CI: 0.81-0.96), respectively). In contrast, competing-risk analysis demonstrated the real-world cumulative dementia incidence is identical in these two groups (subdistribution HR=1.02, 95\% CI: 0.98-1.06), due to higher mortality rate in sulfonylureas group. Prescription of metformin is concluded to be relatively beneficial for dementia prevention among diabetes patients, which needs to be verified in non-diabetes population.