Comparing major and mild cognitive impairment risks in older type-2 diabetic patients: a Danish register-based study on dipeptidyl peptidase-4 inhibitors vs. glucagon-like peptide-1 analogues

This study focuses on the risk of deve loping mild and major CI in Danish patients treated with dipeptidyl peptidase-4 inhibitors (DPP-4i) and glucagon-like peptide-1 analogues (GLP-1a) using administrative and healthcare registers.MethodsAn active comparator design with a 3-year follow-up period was used. The main outcome was the hospital admission with a diagnosis of mild CI or major CI. Multivariate Cox Regression analysis was performed using the high-dimensional propensity score to obtain adjusted Hazard Ratio (HR) estimates. Inverse probability of treatment weighting (IPTW) and marginal structured model were used to calculate risk differences while accounting for the variations of confounders throughout the follow-up period.ResultsOur results show a significant higher risk of major CI between DPP-4i and GLP-1a in unadjusted [HR (95% CI)  = 3.13 (2.45–4.00),p <  0.001] and adjusted analyses [HR (95% CI) = 1.58 (1.22–2.06),p = 0.001]. No statistically significant differences were observed for mild CI. IPTW resulted stable throughout the follow-up period. Marginal structure modeling (β (95% CI) = 0.022 (0.020–0.024),p <  0.001) resulted in a higher risk of major CI for DPP-4i when compared to GLP-1a.DiscussionDPP-4i was associated with an increased risk of developing major CI when compared to GLP-1a among older individuals with type-2 diabetes.
Source: Journal of Neurology - Category: Neurology Source Type: research