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Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis
Abstract
BACKGROUND: Type 2 diabetes (T2D) has been shown to increase dementia risk, but few studies evaluated the relationship between antidiabetic treatment and dementia. METHODS: We followed up 67,731 participants who were nondemented, nondiabetic, aged 65 or over at baseline from January 2004 to December 2009, to observe the onset of T2D (median follow-up 2.4 years), and to compare the risk of the development of dementia associated with particular types of antidiabetic medication among participants with T2D who had solely one type of antidiabetic agents throughout the follow-up period (median follow-up for participants with T2D 3.1 years). RESULTS: The hazard ratio for dementia diagnosis in the new-onset T2D participants compared with the non-T2D participants was 1.56 (95%CI: 1.39-2.18). The relative rate of dementia was 5.31 (95% CI: 1.89-14.96) for participants taking thiazolidinediones (n = 28) and 1.22 (95% CI: 0.78-1.91) for those taking sulfonylureas (n = 796) compared to those taking metformin (n = 1,033). The risk of dementia was higher in ever (n = 841) versus never users (n = 4,579) of thiazolidinediones: 1.44 (95% CI: 1.12-1.86). CONCLUSIONS: Diabetes is associated with an increased risk of dementia. The risk effect becomes weaker provided that participants take sulfonylureas or metformin rather than thiazolidinediones for a longer period.
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TL;DR
In a Taiwanese population-based cohort of adults aged 65 or older, new-onset type 2 diabetes was associated with a higher risk of dementia. Among participants with type 2 diabetes, thiazolidinedione use was associated with a substantially higher dementia rate than metformin, while sulfonylurea use was not significantly different from metformin.
Key findings
- New-onset type 2 diabetes was associated with dementia diagnosis: adjusted HR 1.56 (95% CI 1.39–2.18) versus non-diabetic participants. Dementia rate was 1.78 cases per 100 person-years in T2D participants (n = 147), 1.26 times higher than in non-T2D participants (n = 4,650).
- Among T2D participants taking only one antidiabetic medication, thiazolidinedione users had a higher dementia rate than metformin users: relative rate 5.31 (95% CI 1.89–14.96). Sulfonylurea users did not differ significantly from metformin users: 1.22 (95% CI 0.78–1.91). At study end, dementia was diagnosed in 4/28 TZD users (14.3%), 39/1,033 MET users (3.8%), and 40/796 SU users (5.0%).
- In a separate comparison among T2D participants, any-use of thiazolidinediones versus never-use was associated with dementia: HR 1.44 (95% CI 1.12–1.86).
- In analysis one, hypertension (HR 1.19, 95% CI 1.13–1.25), cerebrovascular disease (HR 1.44, 95% CI 1.33–1.56), and depression (HR 2.12, 95% CI 1.88–2.39) were independently associated with higher dementia risk; hyperlipidemia was not significantly associated.
Methods
- Population-based cohort using Taiwan’s National Health Insurance Research Database / Longitudinal Health Insurance Database 2005. The study followed 67,731 participants aged 65 or older who were dementia-free and T2D-free at baseline in January 2004 through December 2009; median follow-up was 2.4 years for T2D onset and 3.1 years for participants with T2D.
- Four main analyses examined: (1) T2D in relation to dementia; (2) the three most common antidiabetic agents among new-onset T2D participants using solely one medication type and no insulin throughout follow-up (n = 1,857: MET n = 1,033; SUs n = 796; TZDs n = 28); (3) any TZD use (n = 841) versus never-use (n = 4,579); and (4) duration/adherence of medication use.
- Cox proportional hazards regression models were adjusted for age, sex, hypertension, hyperlipidemia, and cerebrovascular disease; Kaplan-Meier survival curves and chi-squared or t tests were also used. Diagnoses were based on ICD-9-CM codes, with dementia defined as at least two dementia diagnosis records within any 1 year and new-onset T2D defined by outpatient/inpatient diagnosis plus oral antidiabetic medication for at least three months.
Limitations
- The authors state selection bias is an important limitation because this was database research rather than a randomized trial; antidiabetic medication selection could be influenced by patients’ clinical condition and physicians’ preferences. They also state they lacked data on HbA1c, drinking, or smoking, and the sample was not large enough for meaningful subgroup analyses stratified by major comorbidities.
- The authors state the follow-up period was relatively short for a chronic disease like dementia, though they argue the median 3.1-year follow-up from T2D onset was reasonable based on prior studies; longer follow-up would make associations more definitive.
- The authors caution that results should be interpreted with caution given the observational design and the relatively small number of TZD users; in analysis two, depression was not included in the regression model because of an inadequate number of cases.
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11 Not checked yet · 6 Own method · 6 Own interpretation · 5 Own result
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The risk of dementia was higher in ever (n = 841) versus never users (n = 4,579) of thiazolidinediones: 1.44 (95% CI: 1.12-1.86).”
- Also stated in: § TZD Risk for Dementia in T2D Participants (Analysis Three) · plain
“the HR of dementia for TZD users versus nonusers was 1.44 (95% CI: 1.12-1.86)after full adjustment (Table 3).”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Abstract
plaincorrelationaln = 841- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § TZD Risk for Dementia in T2D Participants (Analysis Three) · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The hazard ratio for dementia diagnosis in the new-onset T2D participants compared with the non-T2D participants was 1.56 (95%CI: 1.39-2.18).”
- Also stated in: § Comparison of Demographic Characteristics and Risk of Dementia Between T2D and Non-T2D Participants (Analysis One) · plain
“Cox proportional hazards regression analysis showed that the adjusted hazard ratio (HR) of dementia in T2D participants was 1.56 (95% confidence interval (CI): 1.39-2.18)when comparing with non-T2D participants (Table 1).”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Abstract
plaincorrelationaln = 100- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Comparison of Demographic Characteristics and Risk of Dementia Between T2D and Non-T2D Participants (Analysis One) · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The relative rate of dementia was 5.31 (95% CI: 1.89-14.96)for participants taking thiazolidinediones (n = 28) and 1.22 (95% CI: 0.78-1.91)for those taking sulfonylureas (n = 796) compared to those taking metformin (n = 1,033).”
- Also stated in: § Comparison of Demographic Characteristics and Risk of Dementia Among T2D Participants Taking Different Types of Antidiabetic Medications (Analysis Two) · plain
“TZD users had a substantially higher rate of dementia (5.31 [95% CI: 1.89-14.96])compared to the MET users.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Abstract
plaincorrelationaln = 28- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Comparison of Demographic Characteristics and Risk of Dementia Among T2D Participants Taking Different Types of Antidiabetic Medications (Analysis Two) · plain
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“An important limitation is selection bias.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Another important limitation was a relatively short follow-up period with regard to a disease with a chronic course like dementia.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The risk effect becomes weaker provided that participants take sulfonylureas or metformin rather than thiazolidinediones for a longer period.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Abstract
plaindirectn = 28- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“MET and SUs may have more positive effects on cognitive function over TZDs for T2D participants, and an improved compliance increases the benefits.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Unfortunately, we did not have data on health condition that might confound the associations, such as HbA1C, drinking or smoking to control for demographic difference and disease severity.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“MET and SUs had relatively more positive effects on cognitive function than TZDs.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The theoretical positive effects on cognitive function by TZDs, including potent insulin-sensitizing and anti-inflammatory effects, were not supported in our study.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 8
- Probably not a substantial claim. 6
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The relative rate of dementia was similar in the SU compared to MET users (1.22, 95% CI: 0.78-1.91)(Table 3).”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Comparison of Demographic Characteristics and Risk of Dementia Among T2D Participants Taking Different Types of Antidiabetic Medications (Analysis Two)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The rate of dementia in T2D participants was 1.78 cases per 100 person-years (n = 147) which was 1.26 times higher than in non-T2D participants (n = 4,650).”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Comparison of Demographic Characteristics and Risk of Dementia Between T2D and Non-T2D Participants (Analysis One)
plaincorrelationaln = 147- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Significant covariates included in the final model were age, sex, hypertension, hyperlipidemia, and cerebrovascular disease.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The analysis focused on participants taking only one type of antidiabetic medication so that the comparison among the three types of antidiabetic medication could be clearer without interference from influences of other types of antidiabetic medication.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“a recent study suggests MET and sulfonylureas (SUs) may decrease the risk of dementia (15)”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Abstract
What the sources say
- Not checked yetcites [15] 2011, Incidence of dementia is increased in type 2 diabetes and reduced by the use of sulfonylureas and metformin, J Alzheimers Dis source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“One study in cellular models raises the concern that MET might increase the risk of late onset AD because it shows that MET increases the generation of β-amyloid peptides through upregulation of β-secretase (14)”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Abstract
What the sources say
- Not checked yetcites [14] 2009, Antidiabetic drug metformin (GlucophageR) increases biogenesis of Alzheimer's amyloid peptides via up-regulating BACE1 transcription, Proc Natl Acad Sci USA source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Studies showing that metformin (MET) not only reduces insulin levels (11), inflammation and thrombosis (12), and the risk of the metabolic syndrome (13), but also improves insulin sensitivity (11) suggests its potential to exert protective effects on cognitive function.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Abstract
What the sources say
- Not checked yetcites [11] 2005, Role of insulin secretion and sensitivity in the evolution of type 2 diabetes in the diabetes prevention program: effects of lifestyle intervention and metformin, Diabetes source
- Not checked yetcites [12] 2005, Intensive lifestyle intervention or metformin on inflammation and coagulation in participants with impaired glucose tolerance, Diabetes source
- Not checked yetcites [13] 2005, The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial, Ann Intern Med source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“However, many studies have shown that patients tend to develop dementia in a relatively shorter period of time relative to patients without diabetes.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
What the sources say
- Not checked yetcites [4] 2006, Risk of dementia in diabetes mellitus: a systematic review, Lancet Neurol source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“One trial found rosiglitazone was effective in memory and attention (18) but another randomized placebo controlled trial and a Phase III trial failed to demonstrate its effectiveness in cognitive function (19,20).”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Abstract
What the sources say
- Not checked yetcites [18] 2005, Preserved cognition in patients with early Alzheimer disease and amnestic mild cognitive impairment during treatment with rosiglitazone: a preliminary study, Am J Geriatr Psychiatry
- Not checked yetcites [19] 2006, Efficacy of rosiglitazone in a genetically defined population with mild-to-moderate Alzheimer's disease, Pharmacogenomics J source
- Not checked yetcites [20] 2010, A multi-center randomized proof-of-concept clinical trial applying [(1)F]FDG-PET for evaluation of metabolic therapy with rosiglitazone XR in mild to moderate Alzheimer's disease, J Alzheimers Dis
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“TZDs have been consistently shown to have a higher risk of congestive heart failure, myocardial infarction, and other major cardiovascular adverse effects that all contribute to the development of dementia (16,17).”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Abstract
What the sources say
- Not checked yetcites [16] 2005, Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial, Lancet source
- Not checked yetcites [17] 2007, Pioglitazone and risk of cardiovascular events in patients with type 2 diabetes mellitus: a meta-analysis of randomized trials, JAMA source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Trials have failed to demonstrate its effectiveness in dementia patients' cognitive function (19,20), probably due to its adverse cardiovascular effects outweighing potential benefits.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
What the sources say
- Not checked yetcites [19] 2006, Efficacy of rosiglitazone in a genetically defined population with mild-to-moderate Alzheimer's disease, Pharmacogenomics J source
- Not checked yetcites [20] 2010, A multi-center randomized proof-of-concept clinical trial applying [(1)F]FDG-PET for evaluation of metabolic therapy with rosiglitazone XR in mild to moderate Alzheimer's disease, J Alzheimers Dis
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These findings add to the growing evidence of a link between T2D, antidiabetic medication, and dementia.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“The putative mechanisms of MET's positive effects include (i) reducing insulin levels and improving insulin sensitivity (11), (ii) reducing inflammation (11), and (iii) reducing the risk of metabolic syndrome (25).”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
What the sources say
- Not checked yetcites [11] 2005, Role of insulin secretion and sensitivity in the evolution of type 2 diabetes in the diabetes prevention program: effects of lifestyle intervention and metformin, Diabetes source
- Not checked yetcites [25] 2012, Aging biology and novel targets for drug discovery, J Gerontol A Biol Sci Med Sci
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Few studies have explored the association between antidiabetic medications and dementia, and their findings remain controversial.
“Few studies have explored the association between antidiabetic medications and dementia, and their findings remain controversial.”
The paper relies on this without support.
Thiazolidinediones have potent insulin-sensitizing and anti-inflammatory effects that suggest they may theoretically decrease the risk of Alzheimer's disease.
“Although the pharmacological mechanisms of thiazolidinediones (TZDs),the potent insulin-sensitizing and anti-inflammatory effects, suggest that they may theoretically decrease the risk of AD”
The paper relies on this without support.
Sulfonylureas act by increasing blood insulin levels and are not supposed to be advantageous for cognition on a pharmacological basis.
“As for SUs, because they act by increasing blood insulin levels, they are not supposed to be advantageous for cognition on a pharmacological basis.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In a large observational study, 67,731 participants, who had no evidence of dementia, were non-diabetic, and aged ≥ 65 were followed from January 2004 to December 2009, to observe the onset of T2DM and compare the risk of the incidence of dementia associated with the use of anti-diabetic drugs and reported that metformin reduced the risk of developing dementia (256).”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [256]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“A large observational study of metformin-treated T2DM patients reported lower rates of dementia than in those treated with other diabetes medications (Cheng et al., 2014).”
From Metformin as a tool to target aging (2016) · cites this paper as Cheng et al., 2014
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Comparison of Demographic Characteristics and Risk of Dementia Between T2D and Non-T2D Participants (Analysis One)
“We followed up 67,731 participants aged 65 or older, who were initially dementia-free, and T2D-free during the period from January 2004 to December 2009 to observe the development of T2D and then dementia.”
§ Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis > Discussion
“Table 1 . Analysis One: Cox Proportion Hazard Regression Model of T2D and Associated Variables Independently in Relation to Dementia in the Geriatric Cohort (n = 67,731), Followed From January 2004 to June 2009”
Citations
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“Diabetes treatments include lifestyle changes in diet and physical activity, and antidiabetic medications (9,10).”
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Risk of dementia in diabetes mellitus: a systematic review
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Type 2 Diabetes, APOE Gene, and the Risk for Dementia and Related Pathologies
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Cognitive decline and dementia in diabetes—systematic overview of prospective observational studies
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Risner, M. E., Saunders, A. M., Altman, J. F. B., Ormandy, G. C., Craft, S., Foley, I. M., Zvartau-Hind, M. E., Hosford, D. A., Roses, A. D., & for the Rosiglitazone in Alzheimer's Disease Study Group (2006) · The Pharmacogenomics Journal · doi:10.1038/sj.tpj.6500369 · Cited by 686
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Watson, G. S., Cholerton, B. A., Reger, M. A., Baker, L. D., Plymate, S. R., Asthana, S., Fishel, M. A., Kulstad, J. J., Green, P. S., Cook, D. G., et al. (2005) · American Journal of Geriatric Psychiatry · doi:10.1176/appi.ajgp.13.11.950 · Cited by 614
Research works printed but not linked: 1
- Database NHIR, 2007, Introduction to the National Health Insurance Research Database (NHIRD)
Cited by
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Metformin as a tool to target aging
Barzilai, N., Crandall, J. P., Kritchevsky, S. B., & Espeland, M. A. (2016) · Cell Metabolism · doi:10.1016/j.cmet.2016.05.011 · Cited by 1,096
Metformin: a review of its potential indications
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Metadata
- Authors
- Cheng, C., Lin, C.-H., Tsai, Y.-W., Tsai, C.-J., Chou, P.-H., & Lan, T.-H.
- Affiliations
- University of Cambridge (GB)
- Taichung Veterans General Hospital (TW)
- National Health Research Institutes (TW)
- Changhua Christian Hospital (TW)
- Corresponding author
- Lan, Tsuo-Hung
- Venue
- The Journals of Gerontology: Series A
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-06-04
- Volume
- 69
- Issue
- 10
- Pages
- 1299-1305
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- OpenAlex
- W2097594110
- Semantic Scholar
- 276b39aa67f3b7693342d8ac89071206ec0bd7e8
- Cited by
- 167
- References
- 26
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 4 · 2023: 18 · 2022: 20 · 2021: 21 · 2020: 24 · 2019: 23 · 2018: 15 · 2017: 8 · 2016: 9 · 2015: 5 · 2014: 3
- FWCI
- 6.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Health Research Institutes
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- type 2 diabetes, dementia, antidiabetic drugs, thiazolidinediones, sulfonylureas, metformin, dementia risk, older adults, duration of drug use
- MeSH terms
- Aged, Dementia, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Proportional Hazards Models
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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