Abstract

AbstractBackgroundAlzheimer’s Disease and Related Dementias (ADRD) are progressive neurodegenerative disorders that manifest in reduced cognition, executive function and memory impairments. Type 2 Diabetes (T2D) is suggested to be a risk factor for the development of ADRD. In this study, we evaluated the effects of anti‐hyperglycemic medications (HM) to treat hyperglycemia in T2D patients on the incidence of newly diagnosed ADRD.MethodUsing a retrospective analysis of healthcare claims dataset (Mariner 30), patients receiving HM for T2D treatment were identified and survival analysis, stratified by individual therapeutics, was used to determine the association between HM exposure and diagnosis of ADRD. A propensity score approach was used to minimize measured and unmeasured selection bias.ResultIn this cohort study of propensity score matched T2D patients over the age of 45, HM exposure was associated with decrease in diagnosis of ADRD, most specifically AD (RR, 0.61; 95% CI, 0.59‐0.62; P <0.001), Vascular Dementia (RR, 0.72; 95% CI, 0.69‐0.74; P < 0.001) and Dementia (RR, 0.65; 95% CI, 0.64‐0.66; P < 0.001). Patients that did not use HM were more likely to develop an ADRD. The protection by the use of HM was more pronounced after propensity score matching comorbidities significantly correlated with the assignment to HM treatment. Metformin was the most protective and insulin was the least protective compared to patients not taking any HM. The differences between these therapies was not due to age, gender or Charleston Comorbidity Index.ConclusionAfter controlling for age, gender and comorbidities, the use of HM in patients with T2D protected against the development of ADRD.

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