Diabetes drug Metformin slows cognitive decline
Metformin has been used as
first-line treatment safely to treat type 2 diabetes for 60 years. It is most
commonly prescribed medications worldwide, with millions of individuals using
it to optimise their blood sugar levels.
Studies over the last decade have revealed evidence of metformin's benefit in cancer, heart disease, polycystic ovary syndrome and weight management.
Researchers
at Garvan Institute of Medical Research and the Centre for Healthy Brain Ageing
(CHeBA), UNSW Sydney,have found in a new study that individuals with type 2
diabetes who used metformin experienced slower cognitive decline with lower
dementia rates than those who did not use the medication.
The findings provide new hope for a means of reducing the risk of dementia in
individuals with type 2 diabetes, and potentially those without diabetes who
number nearly 47 million people worldwide.
The study has been published in the Journal Diabetes Care.
While
current study suggests that metformin may have cognitive benefits for people
living with type 2 diabetes, the researchers say it may also benefit those at
risk of cognitive decline more broadly.
"We've revealed the promising new potential for a safe and widely used
medication, which could be life-changing for patients at risk of dementia and
their families. For those with type 2 diabetes, metformin may add something
extra to standard glucose lowering in diabetes care: a benefit for cognitive
health," says first author Professor Katherine Samaras, Leader of the
Healthy Ageing Research Theme at the Garvan Institute and endocrinologist at St
Vincent's Hospital Sydney.
Type 2 diabetes occurs when the body can no longer produce enough insulin to
meet its needs, leaving affected individuals unable to maintain blood sugar
levels within a normal range. This can lead to long-term health complications,
including cognitive decline.
"As they age, people living with type 2 diabetes have a staggering 60% risk of developing dementia, a devastating condition that impacts thinking, behaviour, the ability to perform everyday tasks and the ability to maintain independence. This has immense personal, family, economic and societal impacts," says Professor Samaras.
The researchers of this study investigated data from participants of CHeBA's Sydney Memory and Ageing Study. In this cohort, 123 study participants had type 2 diabetes, and 67 received metformin to lower blood sugar levels. The researchers tested cognitive function every two years, using detailed assessments that measured cognition over a number of capabilities, including memory, executive function, attention and speed, and language.
The findings revealed individuals with type 2 diabetes taking metformin had significantly slower cognitive decline and lower dementia risk compared to those not taking metformin. Remarkably, in those with type 2 diabetes taking metformin, there was no difference in the rate of decline in cognitive function over 6 years compared to those without diabetes.
"This study has provided promising initial evidence that metformin may protect against cognitive decline. While type 2 diabetes is thought to increase dementia risk by promoting degenerative pathways in the brain and nerves, these pathways also occur in others at risk of dementia and it is possible insulin resistance may be the mediator," says Professor Samaras.
"To establish a definitive effect, we are now planning a large, randomised controlled trial of metformin in individuals at risk of dementia and assess their cognitive function over three years. This may translate to us being able to repurpose this cheap medication with a robust safety profile to assist in preventing against cognitive decline in older people."
CHeBA's Sydney Memory and Ageing Study is an observational study of older Australians that commenced in 2005 and researches the effects of ageing on cognition over time.
Professor
Perminder Sachdev, senior author of the study and Co-Director of CHeBA, says:
"While an observational study does not provide conclusive 'proof' that
metformin is protective against dementia, it does encourage us to study this
and other anti-diabetic treatments for dementia prevention. Metformin has even
been suggested to be anti-ageing. The intriguing question is whether metformin
is helpful in people in those with normal glucose metabolism. More work is
clearly needed."