DPP-4i Use May Protect in Alzheimer Dementia With Diabetes

Low amyloid burden and favorable cognitive outcomes seen with DPP-4i use in Alzheimer disease-related cognitive impairment with diabetes

THURSDAY, Aug. 12, 2021 (HealthDay News) — For patients with Alzheimer disease-related cognitive impairment (ADCI) and diabetes, dipeptidyl peptidase-4 inhibitor (DPP-4i) use is associated with low amyloid burden and favorable cognitive outcomes, according to a study published online Aug. 11 in Neurology.

Seong Ho Jeong, M.D., from Yonsei University College of Medicine in Seoul, South Korea, and colleagues conducted a retrospective review of 282 patients with ADCI who had a positive scan of ¹⁸F-florbetaben amyloid positron emission tomography images. Patients were classified according to diabetes diagnosis and DPP-4i use: patients with diabetes treated with DPP-4i (ADCI-DPP-4i⁺; 70 patients), patients with diabetes without DPP-4i treatment (ADCI-DPP-4i^−; 71 patients), and patients without diabetes (141 patients).

The researchers found that after adjustment for age, sex, education, cognitive status, and APOE ε4 carrier status, the ADCI-DPP-4i⁺ group had lower global amyloid burden than the ADCI-DPP-4i^− group or the group without diabetes (ß = 0.075 and 0.054, respectively). In addition, compared with the ADCI-DPP-4i^− group or the group without diabetes, the ADCI-DPP-4i⁺ group had lower regional amyloid burden in temporo-parietal areas. A slower longitudinal decrease in Mini-Mental State Examination score and memory recall subscore was seen for the ADCI-DPP-4i⁺ group compared with the ADCI-DPP-4i^− group.

“Not only did our study show that people taking dipeptidyl peptidase-4 inhibitors to lower blood sugar levels had less amyloid in their brains overall, it also showed lower levels in areas of the brain involved in Alzheimer’s disease,” a coauthor said in a statement.

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