Cited by 349

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Increased Risk of Cognitive Impairment in Patients With Diabetes Is Associated With Metformin

Moore, Eileen M., Mander, Alastair G., Ames, David, Kotowicz, Mark A., Carne, Ross P., Brodaty, Henry, Woodward, Michael, Boundy, Karyn, Ellis, Kathryn A., Bush, Ashley I., Faux, Noel G., Martins, Ralph, Szoeke, Cassandra, Rowe, Christopher, Watters, David A., the AIBL Investigators·2013·Diabetes Care

Abstract

OBJECTIVE: To investigate the associations of metformin, serum vitamin B12, calcium supplements, and cognitive impairment in patients with diabetes. RESEARCH DESIGN AND METHODS: Participants were recruited from the Primary Research in Memory (PRIME) clinics study, the Australian Imaging, Biomarkers and Lifestyle (AIBL) study of aging, and the Barwon region of southeastern Australia. Patients with Alzheimer disease (AD) (n = 480) or mild cognitive impairment (n = 187) and those who were cognitively intact (n = 687) were included; patients with stroke or with neurodegenerative diseases other than AD were excluded. Subgroup analyses were performed for participants who had either type 2 diabetes (n = 104) or impaired glucose tolerance (n = 22). RESULTS: Participants with diabetes (n = 126) had worse cognitive performance than participants who did not have diabetes (n = 1,228; adjusted odds ratio 1.51 [95% CI 1.03–2.21]). Among participants with diabetes, worse cognitive performance was associated with metformin use (2.23 [1.05–4.75]). After adjusting for age, sex, level of education, history of depression, serum vitamin B12, and metformin use, participants with diabetes who were taking calcium supplements had better cognitive performance (0.41 [0.19–0.92]). CONCLUSIONS: Metformin use was associated with impaired cognitive performance. Vitamin B12 and calcium supplements may alleviate metformin-induced vitamin B12 deficiency and were associated with better cognitive outcomes. Prospective trials are warranted to assess the beneficial effects of vitamin B12 and calcium use on cognition in older people with diabetes who are taking metformin.

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Figure 1 Recruitment, inclusion, and exclusion.
Figure 1 Recruitment, inclusion, and exclusion.CC BY-NC-ND · PubMed Central

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Cites

Research works printed but not linked: 31

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Metadata

Authors
Moore, E. M., Mander, A. G., Ames, D., Kotowicz, M. A., Carne, R. P., Brodaty, H., Woodward, M., Boundy, K., Ellis, K. A., Bush, A. I., Faux, N. G., Martins, R., Szoeke, C., Rowe, C., Watters, D. A., & the AIBL Investigators
Affiliations
  • The University of Melbourne, Department of Psychiatry, Parkville, Victoria, Australia
  • Barwon Health, Geelong, Victoria, Australia
  • Centre for Healthy Brain Ageing, University of New South Wales, School of Psychiatry, Sydney, Australia
  • Austin Health, Heidelberg Repatriation Hospital, Heidelberg, Victoria, Australia
  • The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
  • Mental Health Research Institute, The University of Melbourne, Parkville, Victoria, Australia
  • Centre of Excellence for Alzheimer’s Disease Research & Care, School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
  • National Ageing Research Institute, Parkville, Victoria, Australia
  • Austin PET Centre, Austin Hospital, Heidelberg, Victoria, Australia.
Venue
Diabetes Care
Published
2013-09-14
Volume
36
Issue
10
Pages
2981-2987
ISSN
  • 0149-5992
  • 1935-5548
Cited by
349
References
9
Language
en

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