Little is known about the heterogeneous treatment effects of metformin on dementia risk in people with type 2 diabetes (T2D).
Participants (≥ 50 years) with T2D and normal cognition at baseline were identified from the National Alzheimer’s Coordinating Center database (2005–2021). We applied a doubly robust learning approach to estimate risk differences (RD) with a 95% confidence interval (CI) for dementia risk between metformin use and no use in the overall population and subgroups identified through a decision tree model.
Among 1393 participants, 104 developed dementia over a 4-year median follow-up. Metformin was significantly associated with a lower risk of dementia in the overall population (RD, –3.2%; 95% CI, –6.2% to –0.2%). We identified four subgroups with varied risks for dementia, defined by neuropsychiatric disorders, non-steroidal anti-inflammatory drugs, and antidepressant use.
Metformin use was significantly associated with a lower risk of dementia in individuals with T2D, with significant variability among subgroups.

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This post is Copyright: Huilin Tang,
Jingchuan Guo,
C. Elizabeth Shaaban,
Zheng Feng,
Yonghui Wu,
Tanja Magoc,
Xia Hu,
William T Donahoo,
Steven T. DeKosky,
Jiang Bian | October 13, 2023

Wiley: Alzheimer’s & Dementia: Table of Contents