SGLT2 inhibitor therapy was associated with a reduced 5-year risk of dementia compared to DPP-4 inhibitors in older adults with type 2 diabetes (HR 0.80; 95% CI 0.70-0.93; p=0.002).
Cohort (n=38,140)
Does SGLT2i therapy reduce the incidence of dementia in older adults with type 2 diabetes compared to DPP-4i?
In older adults with type 2 diabetes, initiating an SGLT2 inhibitor was associated with a significantly lower 5-year risk of developing dementia compared to initiating a DPP-4 inhibitor.
Hazard Ratio: 0.8 (95% CI 0.7–0.93)
Absolute Event Rate: 5.4% vs 6.4%
p-value: p=0.002
BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) are at increased risk of dementia due to hyperglycemia, insulin resistance, and vascular dysfunction. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) may have neuroprotective effects beyond glucose control, but evidence remains limited. This study aimed to assess whether SGLT2i use is associated with a lower incidence of dementia compared to dipeptidyl peptidase-4 inhibitors (DPP-4i) in older adults with T2DM. METHODS: This retrospective cohort study used data from the IQVIA™ Disease Analyzer database in Germany. Patients aged ≥60 years with T2DM, receiving metformin and newly prescribed SGLT2i or DPP-4i (2012-2022), were included. Those with prior neurodegenerative diagnoses were excluded. Propensity score matching (1:1) and Cox proportional hazards models were used to estimate hazard ratios (HR) for dementia over five years. RESULTS: After matching, 38,140 patients were included. Dementia incidence was lower in the SGLT2i group (5.4 %) than the DPP-4i group (6.4 %) (p = 0.002). SGLT2i use was linked to a 20 % reduced dementia risk (HR: 0.80; 95 % CI: 0.70-0.93; p = 0.002), especially in patients >80 years (HR: 0.75) and males (HR: 0.77). CONCLUSIONS: SGLT2i therapy was associated with a lower incidence of dementia in older adults with T2DM, particularly in men and the very elderly.
Sarabhai et al. (Thu,) conducted a cohort in type 2 diabetes mellitus (n=38,140). SGLT2 inhibitors vs. DPP-4 inhibitors was evaluated on incidence of dementia (HR 0.80, 95% CI 0.70-0.93, p=0.002). SGLT2 inhibitor therapy was associated with a reduced 5-year risk of dementia compared to DPP-4 inhibitors in older adults with type 2 diabetes (HR 0.80; 95% CI 0.70-0.93; p=0.002).