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Association of sulfonylureas with the risk of dementia: A population‐based cohort study.

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Title: Association of sulfonylureas with the risk of dementia: A population‐based cohort study.
Authors: Wu, Che‐Yuan, Iskander, Carina, Wang, Christa, Xiong, Lisa Y., Shah, Baiju R., Edwards, Jodi D., Kapral, Moira K., Herrmann, Nathan, Lanctôt, Krista L., Masellis, Mario, Swartz, Richard H., Cogo‐Moreira, Hugo, MacIntosh, Bradley J., Rabin, Jennifer S., Black, Sandra E., Saskin, Refik, Swardfager, Walter
Source: Journal of the American Geriatrics Society. Oct2023, Vol. 71 Issue 10, p3059-3070. 12p.
Subjects: Dementia risk factors, Public health surveillance, Alzheimer's disease, Confidence intervals, Insulin secretagogues, Retrospective studies, Hypoglycemic agents, Risk assessment, Type 2 diabetes, Comparative studies, Descriptive statistics, Research funding, Odds ratio, Longitudinal method, Enzyme inhibitors, Algorithms, Proportional hazards models, Disease complications
Abstract: Background: Sulfonylureas are oral glucose‐lowering medications positioned as a second‐line therapy for type 2 diabetes. Evidence relating them to cognitive decline has been mixed. The objective was to determine whether sulfonylurea use was associated with a differential risk of dementia compared with dipeptidyl peptidase‐4 (DPP4) inhibitor use. Methods: Using administrative data from residents in Ontario, Canada, adults aged ≥66 years who were new users of a sulfonylurea or a DPP4 inhibitor from June 14, 2011, to March 31, 2021 entered this population‐based retrospective cohort study. Dementia was ascertained using a validated algorithm for Alzheimer's disease and related dementias. Propensity‐score weighted Cox proportional hazards models were used to obtain adjusted hazard ratios (aHR) and confidence intervals (CI) for time to incident dementia. The observation window started at 1 year after cohort entry to mitigate protopathic bias due to delayed diagnosis. The primary analysis used an intention‐to‐treat exposure definition. A separate propensity‐score weighted analysis was conducted to explore within‐class differences in dementia risk among sulfonylurea new users selected from the primary cohort. Results: Among 107,806 DPP4 inhibitor new users and 37,030 sulfonylurea new users, sulfonylureas compared with DPP4 inhibitors were associated with a higher risk of dementia (18.4/1000 person‐years; aHR [95% CI] = 1.09 [1.04–1.15]) over a mean follow‐up of 4.82 years from cohort entry. Glyburide compared to gliclazide exhibited a higher dementia risk (aHR [95% CI] = 1.17 [1.03–1.32]). Conclusion: New use of a sulfonylurea especially glyburide was associated with a higher dementia risk compared with new use of a DPP4 inhibitor in older adults with diabetes. See related Editorial by Lee et al. in this issue. [ABSTRACT FROM AUTHOR]
Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Association of sulfonylureas with the risk of dementia: A population‐based cohort study.
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  Data: <searchLink fieldCode="AR" term="%22Wu%2C+Che‐Yuan%22">Wu, Che‐Yuan</searchLink><br /><searchLink fieldCode="AR" term="%22Iskander%2C+Carina%22">Iskander, Carina</searchLink><br /><searchLink fieldCode="AR" term="%22Wang%2C+Christa%22">Wang, Christa</searchLink><br /><searchLink fieldCode="AR" term="%22Xiong%2C+Lisa+Y%2E%22">Xiong, Lisa Y.</searchLink><br /><searchLink fieldCode="AR" term="%22Shah%2C+Baiju+R%2E%22">Shah, Baiju R.</searchLink><br /><searchLink fieldCode="AR" term="%22Edwards%2C+Jodi+D%2E%22">Edwards, Jodi D.</searchLink><br /><searchLink fieldCode="AR" term="%22Kapral%2C+Moira+K%2E%22">Kapral, Moira K.</searchLink><br /><searchLink fieldCode="AR" term="%22Herrmann%2C+Nathan%22">Herrmann, Nathan</searchLink><br /><searchLink fieldCode="AR" term="%22Lanctôt%2C+Krista+L%2E%22">Lanctôt, Krista L.</searchLink><br /><searchLink fieldCode="AR" term="%22Masellis%2C+Mario%22">Masellis, Mario</searchLink><br /><searchLink fieldCode="AR" term="%22Swartz%2C+Richard+H%2E%22">Swartz, Richard H.</searchLink><br /><searchLink fieldCode="AR" term="%22Cogo‐Moreira%2C+Hugo%22">Cogo‐Moreira, Hugo</searchLink><br /><searchLink fieldCode="AR" term="%22MacIntosh%2C+Bradley+J%2E%22">MacIntosh, Bradley J.</searchLink><br /><searchLink fieldCode="AR" term="%22Rabin%2C+Jennifer+S%2E%22">Rabin, Jennifer S.</searchLink><br /><searchLink fieldCode="AR" term="%22Black%2C+Sandra+E%2E%22">Black, Sandra E.</searchLink><br /><searchLink fieldCode="AR" term="%22Saskin%2C+Refik%22">Saskin, Refik</searchLink><br /><searchLink fieldCode="AR" term="%22Swardfager%2C+Walter%22">Swardfager, Walter</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+the+American+Geriatrics+Society%22">Journal of the American Geriatrics Society</searchLink>. Oct2023, Vol. 71 Issue 10, p3059-3070. 12p.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Sulfonylureas are oral glucose‐lowering medications positioned as a second‐line therapy for type 2 diabetes. Evidence relating them to cognitive decline has been mixed. The objective was to determine whether sulfonylurea use was associated with a differential risk of dementia compared with dipeptidyl peptidase‐4 (DPP4) inhibitor use. Methods: Using administrative data from residents in Ontario, Canada, adults aged ≥66 years who were new users of a sulfonylurea or a DPP4 inhibitor from June 14, 2011, to March 31, 2021 entered this population‐based retrospective cohort study. Dementia was ascertained using a validated algorithm for Alzheimer's disease and related dementias. Propensity‐score weighted Cox proportional hazards models were used to obtain adjusted hazard ratios (aHR) and confidence intervals (CI) for time to incident dementia. The observation window started at 1 year after cohort entry to mitigate protopathic bias due to delayed diagnosis. The primary analysis used an intention‐to‐treat exposure definition. A separate propensity‐score weighted analysis was conducted to explore within‐class differences in dementia risk among sulfonylurea new users selected from the primary cohort. Results: Among 107,806 DPP4 inhibitor new users and 37,030 sulfonylurea new users, sulfonylureas compared with DPP4 inhibitors were associated with a higher risk of dementia (18.4/1000 person‐years; aHR [95% CI] = 1.09 [1.04–1.15]) over a mean follow‐up of 4.82 years from cohort entry. Glyburide compared to gliclazide exhibited a higher dementia risk (aHR [95% CI] = 1.17 [1.03–1.32]). Conclusion: New use of a sulfonylurea especially glyburide was associated with a higher dementia risk compared with new use of a DPP4 inhibitor in older adults with diabetes. See related Editorial by Lee et al. in this issue. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/jgs.18397
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        Text: English
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      – SubjectFull: Dementia risk factors
        Type: general
      – SubjectFull: Public health surveillance
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      – SubjectFull: Alzheimer's disease
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      – SubjectFull: Confidence intervals
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      – SubjectFull: Type 2 diabetes
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      – SubjectFull: Comparative studies
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Research funding
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      – SubjectFull: Odds ratio
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      – SubjectFull: Algorithms
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      – SubjectFull: Disease complications
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