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January 19, 2023
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Antidiabetic medication could prevent dementia
Research associates antidiabetic medication use with a lower risk of dementia in diabetic patients. A study compared three common medications: metformin, sulfonylurea, and thiazolidinedione.
Type 2 diabetes (T2D) is related to a higher risk of all-cause dementia including Alzheimer’s and vascular dementia. The links connecting these two conditions are insulin resistance, hyperglycemia, neuroinflammation, and altered energy homeostasis. Initial research highlights the possibility of using antidiabetic medications for dementia prevention and treatment.
Studies associate antidiabetic medication use with a lower risk of dementia in diabetic patients. The use of metformin and thiazolidinedione was reported to improve cognitive function, while sulfonylurea was associated with increased risks of dementia. However, these results were inconsistent.
Using the Veteran Affairs electronic health records, the research team of Tang et al. compared the effects of three commonly prescribed oral antidiabetic medications: metformin (MET), sulfonylurea (SU), and thiazolidinedione (TZD) on dementia onset among veterans with T2D. They followed a cohort of patients with T2D over 16 years. Participants were aged ≥60 years at the initiation of antidiabetic medication treatment and were not carrying dementia diagnosis. Based on prescription records, three test groups were assembled:
- SU monotherapy group
- TZD monotherapy group
- control group treated with MET monotherapy
Participants needed to take the assigned treatment for at least one year. All-cause dementia and the two secondary outcomes – Alzheimer’s and vascular dementia – were observed.
Among the 559,106 eligible veterans studied, the all-cause dementia rate was 8.2 cases per 1000 person-years. TZD monotherapy proved to lead to a 22% lower risk of all-cause dementia onset than MET monotherapy and 11% lower for dual therapy of MET and TZD. Interestingly, the risk was 12% higher for SU monotherapy after at least one year of treatment. Supplementing SU treatment with either MET or TZD may offset its pro-dementia effects.
Thanks to the results of this research, future studies for repurposing oral antidiabetic agents for dementia prevention may consider prioritizing thiazolidinedione use. Patients taking SU could be at a higher risk of dementia than MET or TZD users, and regularly checking cognitive functions is more important to this group.
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Type 2 diabetes (T2D) is related to a higher risk of all-cause dementia including Alzheimer’s and vascular dementia. The links connecting these two conditions are insulin resistance, hyperglycemia, neuroinflammation, and altered energy homeostasis. Initial research highlights the possibility of using antidiabetic medications for dementia prevention and treatment.
Studies associate antidiabetic medication use with a lower risk of dementia in diabetic patients. The use of metformin and thiazolidinedione was reported to improve cognitive function, while sulfonylurea was associated with increased risks of dementia. However, these results were inconsistent.
Using the Veteran Affairs electronic health records, the research team of Tang et al. compared the effects of three commonly prescribed oral antidiabetic medications: metformin (MET), sulfonylurea (SU), and thiazolidinedione (TZD) on dementia onset among veterans with T2D. They followed a cohort of patients with T2D over 16 years. Participants were aged ≥60 years at the initiation of antidiabetic medication treatment and were not carrying dementia diagnosis. Based on prescription records, three test groups were assembled:
- SU monotherapy group
- TZD monotherapy group
- control group treated with MET monotherapy
Participants needed to take the assigned treatment for at least one year. All-cause dementia and the two secondary outcomes – Alzheimer’s and vascular dementia – were observed.
Among the 559,106 eligible veterans studied, the all-cause dementia rate was 8.2 cases per 1000 person-years. TZD monotherapy proved to lead to a 22% lower risk of all-cause dementia onset than MET monotherapy and 11% lower for dual therapy of MET and TZD. Interestingly, the risk was 12% higher for SU monotherapy after at least one year of treatment. Supplementing SU treatment with either MET or TZD may offset its pro-dementia effects.
Thanks to the results of this research, future studies for repurposing oral antidiabetic agents for dementia prevention may consider prioritizing thiazolidinedione use. Patients taking SU could be at a higher risk of dementia than MET or TZD users, and regularly checking cognitive functions is more important to this group.
Article reviewed by
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Dr. Ana Baroni MD. Ph.D.
Scientific & Medical Advisor
Quality Garant
Ana has over 20 years of consultancy experience in longevity, regenerative and precision medicine. She has a multifaceted understanding of genomics, molecular biology, clinical biochemistry, nutrition, aging markers, hormones and physical training. This background allows her to bridge the gap between longevity basic sciences and evidence-based real interventions, putting them into the clinic, to enhance the healthy aging of people. She is co-founder of Origen.life, and Longevityzone. Board member at Breath of Health, BioOx and American Board of Clinical Nutrition. She is Director of International Medical Education of the American College of Integrative Medicine, Professor in IL3 Master of Longevity at Barcelona University and Professor of Nutrigenomics in Nutrition Grade in UNIR University.
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