Metformin use is associated with lower risks of dementia, anxiety and depression: The Hong Kong Diabetes Study
Abstract
Abstract Aims To compare the effects of metformin and sulphonylurea on new-onset dementia, anxiety disorder and depression, and all-cause mortality in patients with type 2 diabetes mellitus. Methods This is a retrospective population-based cohort study of type 2 diabetes mellitus patients exposed to either metformin or sulphonylureas attending the Hospital Authority of Hong Kong between 1 st and 31 st December 2009. The follow-up was until 31 st December 2019. The primary outcome was a new diagnosis of dementia, and anxiety disorder/depression. Propensity score matching (1:1 ratio) between metformin and sulphonylurea users based on demographics, CAIDE score, CHA-DS-VASc score, Charlson comorbidity index, past comorbidities, medications, and total cholesterol was performed. Cox regression was used to identify significant risk predictors. Cause-specific and subdistribution hazard models were also used. Results A total of 89,711 patients (46% men, mean age: 67 years old [SD: 12]) followed-up for 1,579 days (SD: 650). Metformin users were at a lower risk of dementia (before: 0.78 [0.72, 0.84], P-value < 0.0001; after: 0.88 [0.80, 0.97], P-value = 0.0074), anxiety disorder and depression (before: 0.77 [0.69, 0.86], P-value < 0.0001; after: 0.71 [0.61, 0.82], P-value < 0.0001), and all-cause mortality (before: 0.69 [0.68, 0.71], P-value < 0.0001; after: 0.83 [0.80, 0.85], P-value < 0.0001). These associations remained significant in the competing risk models. Conclusion Metformin…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 89,711 participants or records.
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