Increased risk of cognitive impairment in patients with diabetes is associated with metformin

Eileen M. Moore*, Alastair G. Mander, David Ames, Mark A. Kotowicz, Ross P. Carne, Henry Brodaty, Michael Woodward, Karyn Boundy, Kathryn A. Ellis, Ashley I. Bush, Noel G. Faux, Ralph Martins, Cassandra Szoeke, Christopher Rowe, David A. Watters

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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OBJECTIVE To investigate the associations of metformin, serum vitamin B12, calciumsupplements, and cognitive impairment in patients with diabetes. RESEARCH DESIGN AND METHODSdParticipants were recruited from the Primary Research in Memory (PRIME) clinics study, the Australian Imaging, Biomarkers and Lifestyle (AIBL) study of aging, and the Barwon region of southeastern Australia. Patients with Alzheimer disease (AD) (n = 480) or mild cognitive impairment (n = 187) and those who were cognitively intact (n = 687) were included; patients with stroke or with neurodegenerative diseases other than AD were excluded. Subgroup analyses were performed for participants who had either type 2 diabetes (n = 104) or impaired glucose tolerance (n = 22). RESULTSdParticipants with diabetes (n = 126) had worse cognitive performance than participants who did not have diabetes (n = 1,228; adjusted odds ratio 1.51 [95% CI 1.03-2.21]). Among participants with diabetes, worse cognitive performance was associated with metformin use (2.23 [1.05-4.75]). After adjusting for age, sex, level of education, history of depression, serum vitamin B12, and metformin use, participants with diabetes who were taking calcium supplements had better cognitive performance (0.41 [0.19-0.92]). CONCLUSIONSdMetformin use was associated with impaired cognitive performance. Vitamin B12 and calciumsupplementsmay alleviate metformin-induced vitamin B12 deficiency and were associated with better cognitive outcomes. Prospective trials are warranted to assess the beneficial effects of vitamin B12 and calcium use on cognition in older people with diabetes who are taking metformin.

Original languageEnglish
Pages (from-to)2981-2987
Number of pages7
JournalDiabetes Care
Issue number10
Publication statusPublished - Oct 2013
Externally publishedYes

Bibliographical note

Copyright the Author(s) 2013. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Erratum can be found at Diabetes Care volume 36(11), p 3850,


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