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New Evidence Suggests Pioglitazone Reduces Dementia Risk 42%

And the longer the pioglitazone treatment the lower the risk for developing dementia….

Previous studies confirm that diabetes patients have a higher risk of developing dementia than non-diabetics.

Michael Heneka and colleagues conducted a prospective cohort study in 145,928 non-insulin dependent diabetes mellitus aged from 60 or older, who were free of dementia at baseline. The team used observation data from 2004-2010 and classified subjects into non-diabetics, diabetics without pioglitazone, diabetics with prescriptions of less than eight calendar quarters of pioglitazone and diabetics with eight and more quarters. Cox proportional hazard models were used to explore the relative risk of dementia incidence dependent on pioglitazone use adjusted for sex, age, use of rosiglitazone or metformin and cardiovascular comorbidities.

The results showed a lower dementia incidence with pioglitazone with cumulative long-term use of pioglitazone reducing the dementia risk by 47% (RR=0.53, p=0.029) when compared to non-diabetics. Furthermore, if diabetes patients had used pioglitazone less than eight quarters, the dementia risk was comparable to those of non-diabetics (RR=1.16, p=0.317), and diabetes patients without a pioglitazone treatment had a 23% increase in dementia risk (RR=1.23, p<0.001).

Pioglitazone is known to increase the body’s sensitivity to insulin, but it has also been found to protect nerve cells. According to neuroscientist Heneka, “Pioglitazone is an anti-inflammatory drug that also inhibits the deposition of harmful proteins in the brain.” The exact mechanism is still not fully understood. The study suggests the preventive effect of pioglitazone if the drug is taken before symptoms of dementia manifest. But it is unknown as to whether pioglitazone only has this protective effect in diabetics or if it would also work in non-diabetics.

The findings of the study indicate that pioglitazone treatment is associated with reduced dementia risk in initially non-insulin dependent diabetes mellitus patients. Further prospective clinical trials are needed to evaluate a possible neuroprotective effect of pioglitazone different type of population.

Practice Pearls:

  • The risk for developing dementia was about 47 percent lover in diabetes patient taking pioglitazone when compared to non-diabetics.
  • Evidence suggest that pioglitazone inhibits the deposition of harmful proteins in the brain thus appeared to have neuroprotective effect.
  • Study shown that the longer the pioglitazone treatment the lower the risk for developing dementia.

Michael T. Heneka, Anne Fink, Gabriele Doblhammer. Effect of pioglitazone medication on the incidence of dementia. Annals of Neurology, 2015; DOI: 10.1002/ana.24439.