Association between use of sodium-glucose co-transporter-2 inhibitor and the risk of incident dementia: a population-based cohort study
Objectives To assess the association between sodium-glucose co-transporter-2 inhibitor (SGLT-2i) use and the risk of incident dementia compared with dipeptidyl peptidase-4 inhibitors (DPP-4i) use among individuals with type 2 diabetes.Design A population-based retrospective cohort study.Setting The...
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| Language: | English |
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/13/1/e004541.full |
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| author | Robert W Platt Laurent Azoulay Ying Cui Christel Renoux Oriana Hoi Yun Yu Zarin Abdullah Chenjie Xia |
| author_facet | Robert W Platt Laurent Azoulay Ying Cui Christel Renoux Oriana Hoi Yun Yu Zarin Abdullah Chenjie Xia |
| author_sort | Robert W Platt |
| collection | DOAJ |
| description | Objectives To assess the association between sodium-glucose co-transporter-2 inhibitor (SGLT-2i) use and the risk of incident dementia compared with dipeptidyl peptidase-4 inhibitors (DPP-4i) use among individuals with type 2 diabetes.Design A population-based retrospective cohort study.Setting The Clinical Practice Research Datalink (CPRD) Aurum database from the UK.Participants Individuals with type 2 diabetes, aged 40 years or older, newly prescribed SGLT-2i or DPP-4i on or after 2013–2021, registered in the CPRD Aurum database.Main outcome measure The primary outcome was incident dementia, and the secondary outcome was incident mild cognitive impairment (MCI). Cox proportional hazard models were used to estimate the HR and corresponding 95% CI for the primary and secondary outcomes. Propensity score fine stratification weights were used to adjust for confounding.Results Among a cohort of 118 006 individuals, the incident rate (IR) of dementia was 0.56/1000 person-years over a median follow-up period of 1.54 years among SGLT-2i users compared with 2.67/1000 person-years in DPP-4i users, over a median follow-up period of 1.79 years. The adjusted HR for SGLT-2i use compared with DPP-4i use for dementia was 0.78 (95% CI 0.55 to 1.12), while for MCI was 0.86 (95% CI 0.80 to 0.92). The age-specific stratified analysis demonstrated the adjusted HR for SGLT-2i use compared with DPP-4i use for the risk of incident dementia among elderly, aged ≥65 years, was 0.50 (95% CI 0.31 to 0.80).Conclusion Primary findings did not yield conclusive evidence to infer an association between SGLT-2i use and the risk of incident dementia. |
| format | Article |
| id | doaj-art-cc4a2639d3274f1a8303d93442a40ace |
| institution | Kabale University |
| issn | 2052-4897 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj-art-cc4a2639d3274f1a8303d93442a40ace2025-01-23T04:50:12ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972025-01-0113110.1136/bmjdrc-2024-004541Association between use of sodium-glucose co-transporter-2 inhibitor and the risk of incident dementia: a population-based cohort studyRobert W Platt0Laurent Azoulay1Ying Cui2Christel Renoux3Oriana Hoi Yun Yu4Zarin Abdullah5Chenjie Xia6Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, CanadaDepartment of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, CanadaLady Davis Institute for Medical Research Centre for Clinical Epidemiology, Montreal, Québec, CanadaLady Davis Institute for Medical Research Centre for Clinical Epidemiology, Montreal, Québec, CanadaLady Davis Institute for Medical Research Centre for Clinical Epidemiology, Montreal, Québec, CanadaDepartment of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Québec, CanadaDepartment of Neurology and Neurosurgery, McGill University, Montreal, Québec, CanadaObjectives To assess the association between sodium-glucose co-transporter-2 inhibitor (SGLT-2i) use and the risk of incident dementia compared with dipeptidyl peptidase-4 inhibitors (DPP-4i) use among individuals with type 2 diabetes.Design A population-based retrospective cohort study.Setting The Clinical Practice Research Datalink (CPRD) Aurum database from the UK.Participants Individuals with type 2 diabetes, aged 40 years or older, newly prescribed SGLT-2i or DPP-4i on or after 2013–2021, registered in the CPRD Aurum database.Main outcome measure The primary outcome was incident dementia, and the secondary outcome was incident mild cognitive impairment (MCI). Cox proportional hazard models were used to estimate the HR and corresponding 95% CI for the primary and secondary outcomes. Propensity score fine stratification weights were used to adjust for confounding.Results Among a cohort of 118 006 individuals, the incident rate (IR) of dementia was 0.56/1000 person-years over a median follow-up period of 1.54 years among SGLT-2i users compared with 2.67/1000 person-years in DPP-4i users, over a median follow-up period of 1.79 years. The adjusted HR for SGLT-2i use compared with DPP-4i use for dementia was 0.78 (95% CI 0.55 to 1.12), while for MCI was 0.86 (95% CI 0.80 to 0.92). The age-specific stratified analysis demonstrated the adjusted HR for SGLT-2i use compared with DPP-4i use for the risk of incident dementia among elderly, aged ≥65 years, was 0.50 (95% CI 0.31 to 0.80).Conclusion Primary findings did not yield conclusive evidence to infer an association between SGLT-2i use and the risk of incident dementia.https://drc.bmj.com/content/13/1/e004541.full |
| spellingShingle | Robert W Platt Laurent Azoulay Ying Cui Christel Renoux Oriana Hoi Yun Yu Zarin Abdullah Chenjie Xia Association between use of sodium-glucose co-transporter-2 inhibitor and the risk of incident dementia: a population-based cohort study BMJ Open Diabetes Research & Care |
| title | Association between use of sodium-glucose co-transporter-2 inhibitor and the risk of incident dementia: a population-based cohort study |
| title_full | Association between use of sodium-glucose co-transporter-2 inhibitor and the risk of incident dementia: a population-based cohort study |
| title_fullStr | Association between use of sodium-glucose co-transporter-2 inhibitor and the risk of incident dementia: a population-based cohort study |
| title_full_unstemmed | Association between use of sodium-glucose co-transporter-2 inhibitor and the risk of incident dementia: a population-based cohort study |
| title_short | Association between use of sodium-glucose co-transporter-2 inhibitor and the risk of incident dementia: a population-based cohort study |
| title_sort | association between use of sodium glucose co transporter 2 inhibitor and the risk of incident dementia a population based cohort study |
| url | https://drc.bmj.com/content/13/1/e004541.full |
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