Evidence map›Paper›PMID 37395154›Full record

ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2023

Dementia risk in patients with type 2 diabetes: Comparing metformin with no pharmacological treatment.

Bang Zheng, Bowen Su, Sara Ahmadi-Abhari, Dimitrios Kapogiannis, Ioanna Tzoulaki, Elio Riboli, Lefkos Middleton

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 3 pooled it
4.0field-weighted citation impact, top 6% 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

19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
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  13. Long-term metformin use for Alzheimer's disease prevention?Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Article
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  16. Observational
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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

7 authors at 4 institutions in 2 countries.

Bang ZhengAgeing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK.
Bowen SuDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
Sara Ahmadi-AbhariAgeing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK.
Dimitrios KapogiannisLaboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, Baltimore, USA.
Ioanna TzoulakiDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
Elio RiboliDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
Lefkos MiddletonAgeing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK.
Imperial College London · GBImperial College Healthcare NHS Trust · GBLondon School of Hygiene & Tropical Medicine · GBNational Institute on Aging · US

Funding

Studies in Dementia and Neurodegenerative DiseasesZIAAG000975 · NIA · NATIONAL INSTITUTE ON AGING · PI KAPOGIANNIS, DIMITRIOS · 2009 to 2025
$31.5M
Imperial College London - China Scholarship CouncilIntramural NIH HHS Z99 AG999999Intramural NIH HHS ZIA AG000975
6 · The paper itself

Abstract

introductionMetformin has been suggested as a therapeutic agent for dementia, but the relevant evidence has been partial and inconsistent.

methodsWe established a national cohort of 210,237 type 2 diabetes patients in the UK Clinical Practice Research Datalink. Risks of incident dementia were compared between metformin initiators and those who were not prescribed any anti-diabetes medication during follow-up.

resultsCompared with metformin initiators (n = 114,628), patients who received no anti-diabetes medication (n = 95,609) had lower HbA1c and better cardiovascular health at baseline. Both Cox regression and propensity score weighting analysis showed metformin initiators had lower risk of dementia compared to those non-users (adjusted hazard ratio = 0.88 [95% confidence interval: 0.84-0.92] and 0.90 [0.84-0.96]). Patients on long-term metformin treatment had an even lower risk of dementia. DISCUSSION: Metformin may act beyond its glycemic effect and reduce dementia risk to an even lower level than that of patients with milder diabetes and better health profiles. HIGHLIGHTS: Metformin initiators had a significantly lower risk of dementia compared with patients not receiving anti-diabetes medication. Compared with metformin initiators, diabetes patients not receiving pharmacological treatment had better glycemic profiles at baseline and during follow-up. Patients on long-term metformin treatment had an even lower risk of subsequent dementia incidence. Metformin may act beyond its effect on hyperglycemia and has the potential of being repurposed for dementia prevention.

Indexed as

DementiaDiabetes Mellitus, Type 2MetforminHumansHypoglycemic AgentsIncidenceRetrospective StudiesHypoglycemic AgentsMetformincohortdementiadrug repurposingmetformintype 2 diabetes

Identifiers

PMID37395154
PMCPMC12180072
OpenAlexW4382918096

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC
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.