Evidence map›Paper›PMID 34420950›Full record

ArticleJournal of Alzheimer's disease : JAD2021

Alzheimer's Disease-Related Neuropathology Among Patients with Medication Treated Type 2 Diabetes in a Community-Based Autopsy Cohort.

Douglas Barthold, Laura E Gibbons, Zachary A Marcum, Shelly L Gray, C Dirk Keene, Thomas J Grabowski, Nadia Postupna, Eric B Larson, Paul K Crane

Open access · greenAbstract read
In one paragraph

Article in Journal of Alzheimer's disease : JAD, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Douglas BartholdThe Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, Department of Pharmacy, University of Washington, Seattle, WA, USA.
Laura E GibbonsGeneral Internal Medicine, Data Management and Statistics Core, Alzheimer's Disease Research Center, University of Washington, Seattle, WA, USA.
Zachary A MarcumThe Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, Department of Pharmacy, University of Washington, Seattle, WA, USA.
Shelly L GrayThe Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, Department of Pharmacy, University of Washington, Seattle, WA, USA.
C Dirk KeeneLaboratory Medicine and Pathology, School of Medicine, University of Washington, Seattle, WA, USA.
Thomas J GrabowskiDepartments of Radiology and Neurology, UW School of Medicine, Alzheimer's Disease Research Center, University of Washington, Seattle, WA, USA.
Nadia PostupnaLaboratory Medicine and Pathology, School of Medicine, University of Washington, Seattle, WA, USA.
Eric B LarsonKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Paul K CraneDepartment of Medicine, UW School of Medicine, University of Washington, Seattle, WA, USA.
University of Washington · USKaiser Permanente Washington Health Research Institute · US

Funding

Furthering scientific understanding of mechanisms underlying resilience to the effects of AD pathology by incorporating state of the art quantification of gliosis, inflammation, & synaptic toxicityU01AG006781 · NIA · UNIVERSITY OF WASHINGTON · PI CRANE, PAUL K, LARSON, ERIC B · 1986 to 2020
$39.3M
University of Washington Alzheimer's Disease Research CenterP30AG066509 · NIA · UNIVERSITY OF WASHINGTON · PI Amanda D. Boyd · 2020 to 2026
$29.0M
Model for Economic Analysis of Sickle cell cURE (MEASURE)OT3HL152448 · NHLBI · UNIVERSITY OF WASHINGTON · PI BASU, ANIRBAN · 2019 to 2019
$3.3M
Reducing CNS-active Medications to Prevent Falls and Injuries in Older AdultsU01CE002967 · CE · UNIVERSITY OF WASHINGTON · PI GRAY, SHELLY L, PHELAN, ELIZABETH ANNE · 2018 to 2021
$2.9M
Acceptability of Sustained-Release Antiretrovirals for Treatment in the US and sub-Saharan AfricaR01MH121424 · NIMH · UNIVERSITY OF WASHINGTON · PI GRAHAM, SUSAN MARIE · 2019 to 2023
$2.4M
Antihypertensives and the Aging BrainK76AG059929 · NIA · UNIVERSITY OF WASHINGTON · PI MARCUM, ZACHARY ADAM · 2019 to 2021
$694k
ACL HHS U01CE002967NCIPC CDC HHS U01 CE002967NHLBI NIH HHS OT3 HL152448NIA NIH HHS K76 AG059929NIA NIH HHS P30 AG066509NIA NIH HHS U01 AG006781NIMH NIH HHS R01 MH121424
6 · The paper itself

Abstract

backgroundDiabetes is a risk factor for Alzheimer's disease and related dementias (ADRD). Epidemiologic evidence shows an association between diabetes medications and ADRD risk; cell and mouse models show diabetes medication association with AD-related neuropathologic change (ADNC).

objectiveThis hypothesis-generating analysis aimed to describe autopsy-measured ADNC for individuals who used diabetes medications.

methodsDescriptive analysis of ADNC for Adult Changes in Thought (ACT) Study autopsy cohort who used diabetes medications, including sulfonylureas, insulin, and biguanides; total N = 118. ADNC included amyloid plaque distribution (Thal phasing), neurofibrillary tangle (NFT) distribution (Braak stage), and cortical neuritic plaque density (CERAD score). We also examined quantitative measures of ADNC using the means of standardized Histelide measures of cortical PHF-tau and Aβ1-42. Adjusted analyses control for age at death, sex, education, APOE genotype, and diabetes complication severity index.

resultsAdjusted analyses showed no significant association between any drug class and traditional neuropathologic measures compared to nonusers of that class. In adjusted Histelide analyses, any insulin use was associated with lower mean levels of Aβ1-42 (-0.57 (CI: -1.12, -0.02)) compared to nonusers. Five years of sulfonylureas and of biguanides use was associated with lower levels of Aβ1-42 compared to nonusers (-0.15 (CI: -0.28, -0.02), -0.31 (CI: -0.54, -0.07), respectively).

conclusionSome evidence exists that diabetes medications are associated with lower levels of Aβ1-42, but not traditional measures of neuropathology. Future studies are needed in larger samples to build understanding of the mechanisms between diabetes, its medications, and ADRD, and to potentially repurpose existing medications for prevention or delay of ADRD.

Indexed as

AutopsyAgedAged, 80 and overAlzheimer DiseaseAmyloid beta-PeptidesBiguanidesDiabetes Mellitus, Type 2FemaleHumansHypoglycemic AgentsInsulinMaleNeurofibrillary TanglesNeuropathologyPeptide FragmentsProspective StudiesAmyloid beta-Peptidesamyloid beta-protein (1-42)BiguanidesHypoglycemic AgentsInsulinPeptide FragmentsSulfonylurea CompoundsAlzheimer’s diseasedementiadiabetes treatmentsneuropathology

Identifiers

PMID34420950
PMCPMC8846930
OpenAlexW3195994108

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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 Socratic graph.