Validity of Montreal Cognitive Assessment to Detect Cognitive Impairment in Individuals with Type 2 Diabetes DOI Creative Commons
Anu Gupta, Alpesh Goyal, Roopa Rajan

et al.

Diabetes Therapy, Journal Year: 2024, Volume and Issue: 15(5), P. 1155 - 1168

Published: March 23, 2024

Guidelines recommend screening older people (> 60–65 years) with type 2 diabetes (T2D) for cognitive impairment, as it has implications in the management of diabetes. The Montreal Cognitive Assessment (MoCA) is a sensitive test detection mild impairment (MCI) general population, but its validity T2D not been established. We administered MoCA to patients (age ≥ 60 and controls (no T2D), along culturally validated neuropsychological battery functional activity questionnaire. MCI was defined performance one or more domains 1.0 SD below control group (on two tests representing domain), preserved activities. discriminant diagnosis at different cut-offs ascertained. enrolled 267 120 controls; 39% participants met diagnostic criteria on detailed testing. At recommended cut-off (< 26), sensitivity (94.2%) high, specificity quite low (29.5%). score < 23 showed an optimal trade-off between (69.2%), (71.8%), accuracy (70.8%). 21 exhibited highest (74.9%) excellent (91.4%), good positive negative predictive value (78.5% 73.7%, respectively). point 26 suboptimal may increase referral burden memory clinics. A lower maximizes accuracy. Interactive Visual Abstract available this article. Type risk factor dysfunction which potentially impacts self-management skills. adults early impairment. For busy endocrine clinics, we need that easy rapid administer, enough pick deficits same time gives less false-positive outcomes. scale widely tool, there are no studies evaluating properties evaluated metrics population. found four out ten above years age. low. better (20/21), high sensitivity. cut-off, approximately five screened using would require testing, who undergo evaluation have true

Language: Английский

Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission DOI
Gill Livingston, Jonathan Huntley, Kathy Liu

et al.

The Lancet, Journal Year: 2024, Volume and Issue: 404(10452), P. 572 - 628

Published: July 31, 2024

Language: Английский

Citations

645
Sodium-glucose cotransporter-2 inhibitors and their potential role in dementia onset and cognitive function in patients with diabetes mellitus: a systematic review and meta-analysis DOI Creative Commons

Y J Youn,

Seung Yeon Kim,

Hyun‐Jeong Jeong

et al.

Frontiers in Neuroendocrinology, Journal Year: 2024, Volume and Issue: 73, P. 101131 - 101131

Published: Feb. 16, 2024

This systematic review and meta-analysis aimed to determine the association between use of sodium-glucose cotransporter 2 (SGLT-2) inhibitors dementia onset as well cognitive function in patients with diabetes mellitus. We comprehensively searched MEDLINE, Embase, CENTRAL databases select relevant studies published up August 2023. The SGLT-2 significantly lowers risk compared SGLT-2i non-users (Hazard ratio: 0.68, 95 % CI: 0.50-0.92). Furthermore, our findings indicated a positive effect inhibitor on score improvement, demonstrated by standardized mean difference 0.88 (95 0.32-1.44), particularly among populations mild impairment or dementia. indicate potential role reducing These underscore need for well-controlled large clinical trials future research this field.

Language: Английский

Citations

25
Impact of Sodium Glucose Cotransporter 2 Inhibitors (SGLT2i) Therapy on Dementia and Cognitive Decline DOI Creative Commons

Antonio Lardaro,

L. Quarta,

Stefania Pagnotta

et al.

Biomedicines, Journal Year: 2024, Volume and Issue: 12(8), P. 1750 - 1750

Published: Aug. 3, 2024

Dementia is an age-related syndrome characterized by the progressive deterioration of cognition and capacity for independent living. Diabetes often associated with cognitive decline shares similar pathophysiological mechanisms dementia, such as systemic inflammation, oxidative stress, insulin resistance, advanced glycation end-products formation. Therefore, adequate diabetes management may reduce risk decline, especially in patients other comorbidities factors. The sodium glucose cotransporter inhibitors (SGLT2i) regulate renal reabsorption blocking SGLT2 cotransporters located proximal tubules, causing glycosuria intraglomerular pressure reduction. Their use helps to lower blood modifying water homeostasis; these drugs are also commonly used treatment heart failure chronic kidney disease, while recently, a potential neuroprotective role central nervous system has been suggested. aim our scoping review analyze current evidence about effects SGLT2i adult patients. We performed literature evaluate effect on mild impairment (MCI) Alzheimer's disease incidence progression. screening process was through different searches PubMed EMBASE, evaluating original works published up January 2024. In conclusion, could be diabetes, reducing or progression MCI dementia. Further prospective studies needed validate this hypothesis effectiveness class normal glycemic profile

Language: Английский

Citations

19
Risk of dementia after initiation of sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors in adults aged 40-69 years with type 2 diabetes: population based cohort study DOI Creative Commons
Anna Shin, Bo Kyung Koo,

Jun Young Lee

et al.

BMJ, Journal Year: 2024, Volume and Issue: unknown, P. e079475 - e079475

Published: Aug. 28, 2024

To compare the risk of dementia associated with sodium-glucose cotransporter-2 (SGLT-2) inhibitors versus dipeptidyl peptidase-4 (DPP-4) in adults aged 40-69 years type 2 diabetes.

Language: Английский

Citations

18
GLP-1RA and SGLT2i Medications for Type 2 Diabetes and Alzheimer Disease and Related Dementias DOI
Huilin Tang, William T. Donahoo, Steven T. DeKosky

et al.

JAMA Neurology, Journal Year: 2025, Volume and Issue: unknown

Published: April 7, 2025

Importance The association between glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) risk of Alzheimer disease related dementias (ADRD) remains to be confirmed. Objective To assess the ADRD associated with GLP-1RAs SGLT2is in people type 2 diabetes (T2D). Design, Setting, Participants This target trial emulation study used electronic health record data from OneFlorida+ Clinical Research Consortium January 2014 June 2023. Patients were 50 years or older T2D no prior diagnosis antidementia treatment. Among 396 963 eligible patients T2D, 33 858 included GLP-1RA vs other glucose-lowering drug (GLD) cohort, 34 185 SGLT2i GLD 24 117 cohort. Exposures Initiation treatment a GLP-1RA, SGLT2i, second-line GLD. Main Outcomes Measures was identified using clinical codes. Hazard ratios (HRs) 95% CIs estimated Cox proportional hazard regression models inverse probability weighting (IPTW) adjust for potential confounders. Results cohort (mean age, 65 years; 53.1% female), 65.8 49.3% 63.8 51.7% female). In IPTW-weighted cohorts, incidence rate lower initiators compared (rate difference [RD], −2.26 per 1000 person-years [95% CI, −2.88 −1.64]), yielding an HR 0.67 (95% 0.47-0.96). had than (RD, −3.05 −3.68 −2.42]), 0.57 0.43-0.75). There SGLT2is, RD −0.09 −0.80 0.63) 0.97 0.72-1.32). Conclusion Relevance both statistically significantly decreased GLDs, observed drugs.

Language: Английский

Citations

4
An analysis on the role of glucagon-like peptide-1 receptor agonists in cognitive and mental health disorders DOI Creative Commons
Riccardo De Giorgi, Ana Ghenciulescu,

Oliwia Dziwisz

et al.

Nature Mental Health, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 13, 2025

Abstract Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are novel drugs approved for diabetes and obesity. They acknowledged as a major scientific breakthrough. In addition to their metabolic effects, these medications act on other bodily systems involved in the physiopathology of various neurological psychiatric disorders. Several stakeholders calling more research investigate repurposing potential GLP-1RAs cognitive mental disorders, while others advocate better assessment safety profile from neuropsychiatric perspective. this Analysis, we searched relevant literature effects across range illnesses, gathering describing available pre-clinical mechanistic (278 studies) clinical (96 evidence substance-use psychotic mood anxiety eating others. By leveraging translational insights data, consider implications practice propose avenues further research.

Language: Английский

Citations

3
Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Nervous System Disorders: A Systematic Review and Meta-Analysis DOI
Bo Xu,

Mingxia Yang,

Shaoqian Li

et al.

Annals of Pharmacotherapy, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 23, 2025

Background: Adults with type 2 diabetes mellitus (T2DM) are at an increased risk for certain brain or psychiatric disorders, as those without chronic kidney disease heart failure. Whether sodium-glucose cotransporter (SGLT2) inhibitors associated these diseases is unclear. Objective: This systematic review and meta-analysis aimed to investigate the effects of SGLT2 on nervous system disorders. Methods: We searched PubMed, ClinicalTrials.gov, Web Science randomized, double-blind placebo-controlled trials least ≥24 weeks. used Mantel–Haenszel statistical method, ratio (RR), 95% confidence interval (CI) dichotomous variables. Results: included 52 publications/trials covering 111 376 participants (SGLT2 62 192; Placebo 49 184). Sodium-glucose had no significant effect ischaemic stroke (RR = 0.97; CI 0.87-1.09; P 0.64), cerebrovascular accident 1.05; 0.91-1.22; 0.50), dementia 1.29; 0.78-2.12; 0.32), carotid artery occlusion/carotid stenosis 1.18; CI: 0.92-1.53; 0.20), haemorrhagic 0.84; 0.62-1.12; 0.23), transient attack 0.82-1.15; 0.73) compared placebo. No heterogeneity was observed. However, showed slight reduce Parkinson’s (major failure subgroup). Empagliflozin dapagliflozin significantly syncope 1.65; 1.15-2.38; < 0.01) 1.04-2.61; 0.03), respectively. Conclusion Relevance: disorders There reduced Disease observed in some specific populations. In addition, risks empagliflozin concerning worth attention.

Language: Английский

Citations

3
Cardioprotective Glucose-Lowering Agents and Dementia Risk DOI

Allie Seminer,

Alfredi Mulihano,

Clare O’Brien

et al.

JAMA Neurology, Journal Year: 2025, Volume and Issue: unknown

Published: April 7, 2025

Importance Although diabetes is a risk factor for dementia, the effect of glucose-lowering therapy prevention incident dementia uncertain. Objective To determine whether cardioprotective (sodium-glucose cotransporter-2 inhibitors [SGLT2is], glucagon-like peptide-1 receptor agonists [GLP-1RAs], metformin, and pioglitazone), compared with controls, was associated reduction in or cognitive impairment, among primary subtypes. Data Sources The PubMed Embase databases were searched studies published from inception database to July 11, 2024. Study Selection Randomized clinical trials comparing controls that reported change scores. Cardioprotective therapies defined as drug classes recommended by guidelines cardiovascular events, based on evidence phase III randomized trials. Inclusion criteria assessed independently inconsistencies resolved consensus. Extraction Synthesis screened extracted 2 authors adhering PRISMA August Random-effects meta-analysis models used estimate pooled treatment effect. Main Outcomes Measures outcome measure impairment. secondary outcomes subtypes, including vascular Alzheimer Results Twenty-six eligible inclusion (N = 164 531 participants), which 23 (n 160 191 participants) incidence 12 evaluating SGLT2is, 10 GLP-1RAs, 1 trial pioglitazone (no metformin identified). mean (SD) age participants 64.4 (3.5) years 57 470 (34.9%) women. Overall, not significantly impairment (odds ratio [OR], 0.83 [95% CI, 0.60-1.14]). Among classes, GLP-1RAs statistically significant (OR, 0.55 0.35-0.86]), but SGLT2is 1.20 0.67-2.17]; P value heterogeneity .04). Conclusions Relevance While an overall all-cause this found glucose lowering dementia.

Language: Английский

Citations

3
Comparative Effectiveness of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Preventing Alzheimer's Disease, Vascular Dementia, and Other Dementia Types Among Patients with Type 2 Diabetes DOI
Mingyang Sun, Xiaoling Wang, Zhongyuan Lu

et al.

Diabetes & Metabolism, Journal Year: 2025, Volume and Issue: unknown, P. 101623 - 101623

Published: Feb. 1, 2025

Language: Английский

Citations

2
Diabetes, antidiabetic medications and risk of dementia: A systematic umbrella review and meta‐analysis DOI Creative Commons
Alvin Kuate Defo,

Veselko Bakula,

Alessandro Pisaturo

et al.

Diabetes Obesity and Metabolism, Journal Year: 2023, Volume and Issue: 26(2), P. 441 - 462

Published: Oct. 23, 2023

Abstract Aims The objective of this umbrella review and meta‐analysis was to evaluate the effect diabetes on risk dementia, as well mitigating antidiabetic treatments. Materials Methods We conducted a systematic its treatment, focusing treatment. searched MEDLINE/PubMed, Embase, PsycINFO, CINAHL Cochrane Library for reviews meta‐analyses assessing cognitive decline/dementia in individuals with until 2 July 2023. random‐effects obtain ratios 95% confidence intervals estimating association metformin, thiazolidinediones, pioglitazone, dipeptidyl peptidase‐4 inhibitors, α‐glucosidase meglitinides, insulin, sulphonylureas, glucagon‐like peptide‐1 receptor agonists (GLP1RAs) sodium‐glucose cotransporter‐2 inhibitors (SGLT2is) dementia from cohort/case‐control studies. subgroups analysed included country world region. Risk bias assessed AMSTAR tool Newcastle‐Ottawa Scale. Results 100 27 studies (N = 3 046 661). Metformin, GLP1RAs SGLT2is were associated significant reduction dementia. When examining metformin divided by country, only United States. Moreover, Western but not Eastern populations. No observed or while meglitinides sulphonylureas increased risk. Conclusions reduced More longitudinal aimed at determining their relative benefit different populations should be conducted.

Language: Английский

Citations

33