Abstract
This study investigated whether rosiglitazone might increase or reduce dementia risk. Taiwan’s National Health Insurance database was used to enroll a cohort of 1:1 matched-pairs of ever and never users of rosiglitazone based on propensity score from patients with new-onset type 2 diabetes during 1999-2006. The patients were alive on January 1, 2007 and were followed up for dementia until December 31, 2011. A total of 5,048 pairs of never users and ever users were identified. The incident case numbers were 127 and 121, respectively. The adjusted hazard ratio for ever versus never users was 0.895 (95% confidence interval: 0.696-1.151). The adjusted hazard ratios for the first (<12.1 months), second (12.1-25.1 months) and third (>25.1 months) tertiles of cumulative duration of rosiglitazone therapy were 0.756 (0.509-1.123), 0.964 (0.685-1.357) and 0.949 (0.671-1.341), respectively. When cumulative duration was treated as a continuous variable, the adjusted hazard ratio was 1.000 (0.992-1.008). Subgroup analyses conducted in ever users and never users of metformin and in patients diagnosed with diabetes during three different periods of time, i.e., 1999-2000, 2001-2003 and 2004-2006, all supported a neutral effect of rosiglitazone. In conclusion, rosiglitazone does not increase or redcue the risk of dementia.
Highlights
Dementia is a clinical presentation characterized by progressive deterioration of cognitive functions such as memory, thinking and reasoning and behavioral abilities for daily life and self-care
The findings suggested that rosiglitazone use in patients with type 2 diabetes mellitus had a neutral effect on the risk of dementia (Tables 2-4)
It is interesting that the risk of dementia was decreased in association with the use of metformin [12] and pioglitazone [13] in our previous studies but not associated with rosiglitazone in the present study
Summary
Dementia is a clinical presentation characterized by progressive deterioration of cognitive functions such as memory, thinking and reasoning and behavioral abilities for daily life and self-care. Insulin resistance in the brain can be observed in patients with Alzheimer’s disease [13]. Some experts coined the term “type 3 diabetes” in 2005 [1] to reflect the close link between diabetes mellitus and Alzheimer’s disease, because they share potential common pathophysiological changes of impaired insulin expression and insulin resistance [1,2,3]. The increased risk of dementia in diabetes patients may be explained by some pathophysiological changes related to diabetes mellitus that lead to atherosclerosis and neurodegeneration, including insulin resistance, increased inflammation and oxidative stress, deposition of advanced glycation end-products and lipid dysregulation [4]. Increased deposition of amyloid beta (Aβ) and hyperphosphorylation of Tau protein are important pathological changes in the brain of patients with Alzheimer’s disease [2]. Aβ is formed by cleaving the www.aging-us.com
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