ArticleAnnals of family medicine2019
Association Between Metformin Initiation and Incident Dementia Among African American and White Veterans Health Administration Patients.
Article in Annals of family medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Effect of antidiabetic drugs in Alzheimer´s disease: a systematic review of preclinical and clinical studies.Molecular neurodegeneration · 2025Pooled it
- Effect of diabetes medications on the risk of developing dementia, mild cognitive impairment, or cognitive decline: A systematic review and meta-analysis.Journal of Alzheimer's disease : JAD · 2025Pooled it
- Metformin use is associated with a reduced risk of cognitive impairment in adults with diabetes mellitus: A systematic review and meta-analysis.Frontiers in neuroscience · 2022Pooled it
- Tetanus, diphtheria and pertussis vaccination and risk for incident dementia among adults with down syndrome.The journal of prevention of Alzheimer's disease · 2026Article
- Beta cells to brain cells: The pivotal role of insulin and glucose metabolism in Alzheimer's disease.Neuroprotection (Chichester, England) · 2025Review
- Metformin mitigates dementia risk among individuals with type 2 diabetes.Clinical diabetes and endocrinology · 2024Review
- Severity of posttraumatic stress disorder, type 2 diabetes outcomes and all-cause mortality: A retrospective cohort study.Journal of psychosomatic research · 2023Article
- Review
- Long-term use of metformin and Alzheimer's disease: beneficial or detrimental effects.Inflammopharmacology · 2023Review
- Association Between Metformin Use and Cognitive and Physical Function in Persons with HIV and Diabetes.AIDS research and human retroviruses · 2023Observational
- Causal inference in medical records and complementary systems pharmacology for metformin drug repurposing towards dementia.Nature communications · 2022Article
- The potential benefit of metformin to reduce delirium risk and mortality: a retrospective cohort study.Aging · 2022Article
- Comparative effect of metformin versus sulfonylureas with dementia and Parkinson's disease risk in US patients over 50 with type 2 diabetes mellitus.BMJ open diabetes research & care · 2022Article
- Anti-diabetic Potential of Indigenous Medicinal Plants of Cholistan Desert, Pakistan: A Review.The review of diabetic studies : RDS · 2022Review
- Comparison of rates of dementia among older adult recipients of two, one, or no vaccinations.Journal of the American Geriatrics Society · 2022Article
- Metformin and Dementia Risk: A Systematic Review with Respect to Time Related Biases.Journal of Alzheimer's disease reports · 2022Article
- Association Between Specific Type 2 Diabetes Therapies and Risk of Alzheimer's Disease and Related Dementias in Propensity-Score Matched Type 2 Diabetic Patients.Frontiers in aging neuroscience · 2022Article
- Metformin a Potential Pharmacological Strategy in Late Onset Alzheimer's Disease Treatment.Pharmaceuticals (Basel, Switzerland) · 2021Review
- Baseline Neurocognitive Impairment (NCI) Is Associated With Incident Frailty but Baseline Frailty Does Not Predict Incident NCI in Older Persons With Human Immunodeficiency Virus (HIV).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Observational
- Impact of herpes zoster vaccination on incident dementia: A retrospective study in two patient cohorts.PloS one · 2021Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
purposeAfrican American patients are more likely to experience cognitive decline after type 2 diabetes mellitus onset than white patients. Metformin use has been associated with a lower risk of dementia compared with sulfonylureas. Evidence for whether this association differs by race is sparse.
methodsVeterans Health Administration (VHA) medical record data were obtained for 73,761 African American and white patients aged ≥50 years who used the VHA from fiscal years 2000 to 2015. Patients were free of dementia and diabetes medications during fiscal years 2000 and 2001 and subsequently initiated metformin or sulfonylurea monotherapy. For race and age subgroups, Cox proportional hazards models using propensity scores and inverse probability of treatment weighting to control for confounding were computed to measure the association between metformin vs sulfonylurea initiation and incident dementia.
resultsAfter controlling for confounding, among patients aged ≥50 years, metformin vs sulfonylurea use was associated with a significantly lower risk of dementia in African American patients (hazard ratio [HR] = 0.73; 95% CI, 0.6-0.89) but not white patients (HR = 0.96; 95% CI, 0.9-1.03). The strongest magnitude of association between metformin and dementia was observed among African American patients aged 50 to 64 years (HR = 0.6; 95% CI, 0.45-0.81). Among those aged 65 to 74 years, metformin was significantly associated with lower risk of dementia in both races. Metformin was not associated with dementia in patients aged ≥75 years.
conclusionsMetformin vs sulfonylurea initiation was associated with a substantially lower risk of dementia among younger African American patients. These results may point to a novel approach for reducing the risk of dementia in African Americans with type 2 diabetes mellitus.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.