Year: 2013
Type: article
Abstract: Diabetes increases the risk for Alzheimer's disease (AD). However, the use of diabetes medications may offer protection against AD-related cognitive decline in diabetic elders. We investigated the association of different diabetes medication types and cognitive trajectory among elders with normal cognition (NC), mild cognitive impairment (MCI), and AD. National Alzheimer's Coordinating Center data was accessed on 921 NC, MCI, and AD elders (aged 74±8, 60% female) followed for 1.4±1.8 years. All participants were diabetic and reported taking one diabetes medication type during the follow-up period, including injected insulin (n=154; INJ), thiazolidinediones (n=49; TZD), metformin (n=417; MET), combined TZD/MET (n=52), combined secretagogues (n=217; SECR), GLP-1 agonists (n=10; GLP), and combined GLP-1 and MET (n=18). Annual neuropsychological data included the Mini-Mental State Exam (MMSE), Wechsler Memory Scale Revised (WMS-R) Immediate and Delayed Recall, Boston Naming Test (BNT), Animal and Vegetable Fluency, WMS-R Digit Span Forward and Backward, Wechsler Adult Intelligence Scale-Revised (WAIS-R) Digit Symbol Coding, and Trail Making Test (TMT) Parts A & B. Adjusting for age, sex, education, and race, linear mixed models revealed that individuals taking INJ (i.e., the referent) had significant decline in cognition over the follow-up period on the MMSE (β=-0.59, p=0.00), WMS-R Immediate memory (β=-0.23, p=0.04), animal fluency (β=-0.47, p=0.00), vegetable fluency (β=-0.44, p=0.00), TMT-A (β=2.22, p=0.01), WAIS-R Digit Symbol Coding (β=-1.31, p=0.00), and BNT (β=-0.26, p=0.03). Individuals taking SECR had faster decline on the BNT (β=-0.76, p=0.00) compared to the referent. The GLP group had faster decline on Digit Span Backward (β=-1.79, p=0.00) compared to the referent. Findings suggest that diabetes medications have an impact on cognitive trajectory. Elders taking injected insulin show decline in most cognitive domains over the follow-up period; however, elders taking GLP-1 agonists and secretagogues have accelerated cognitive decline in naming and working memory compared to elders taking injected insulin.
Source: Alzheimer s & Dementia
Authors: Elizabeth Lane, Dandan Lui, Zengqi Lu, Kevin Niswender, Angela Jefferson
Institution: Vanderbilt University Medical Center
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1964869554