Author, as appears in the article.: Soldevila-Domenech, Natalia; Cuenca-Royo, Aida; Babio, Nancy; Forcano, Laura; Nishi, Stephanie; Vintro-Alcaraz, Cristina; Gomez-Martinez, Carlos; Jimenez-Murcia, Susana; Fernandez-Carrion, Rebeca; Gomis-Gonzalez, Maria; Alvarez-Sala, Andrea; Carlos, Silvia; Pinto, Xavier; Corella, Dolores; Diez-Espino, Javier; Castaner, Olga; Fernandez-Aranda, Fernando; Salas-Salvado, Jordi; de la Torre, Rafael;
Department: Bioquímica i Biotecnologia
URV's Author/s: Babio Sánchez, Nancy Elvira / Salas Salvadó, Jorge
Keywords: Type 2 diabetes Risk Prevention Overweight Obesity Nutrition Metformin Metabolic syndrome Memory Mediterranean diet Insulin-resistance Impairment Drugs Dementia Decline Cognition
Abstract: Background and Purpose: Both adherence to the Mediterranean diet (MedDiet) and the use of metformin could benefit the cognitive performance of individuals with type 2 diabetes, but evidence is still controversial. We examined the association between metformin use and cognition in older adults with type 2 diabetes following a MedDiet intervention.</p>Methods: Prospective cohort study framed in the PREDIMED-Plus-Cognition sub-study. The PREDIMED-Plus clinical trial aims to compare the cardiovascular effect of two MedDiet interventions, with and without energy restriction, in individuals with overweight/obesity and metabolic syndrome. The present sub-study included 487 cognitively normal subjects (50.5% women, mean +/- SD age of 65.2 +/- 4.7 years), 30.4% of them (N = 148) with type 2 diabetes. A comprehensive battery of neurocognitive tests was administered at baseline and after 1 and 3 years. Individuals with type 2 diabetes that exhibited a good glycemic control trajectory, either using or not using metformin, were compared to one another and to individuals without diabetes using mixed-effects models with inverse probability of treatment weights.</p>Results: Most subjects with type 2 diabetes (83.1%) presented a good and stable glycemic control trajectory. Before engaging in the MedDiet intervention, subjects using metformin scored higher in executive functions (Cohen's d = 0.51), memory (Cohen's d = 0.38) and global cognition (Cohen's d = 0.48) than those not using metformin. However, these differences were not sustained during the 3 years of follow-up, as individuals not using metformin experienced greater improvements in memory (beta = 0.38 vs. beta = 0.10, P = 0.036), executive functions (beta = 0.36 vs. beta = 0.02, P = 0.005) and global cognition (beta = 0.29 vs. beta = -0.02, P = 0.001) that combined with a higher MedDiet adherence (12.6 vs. 11.5 points, P = 0.031). Finally, subjects without diabetes presented greater improvements in memory than subjects with diabetes irrespective of their exposure to metformin (beta = 0.55 vs. beta = 0.10, P < 0.001). However, subjects with diabetes not using metformin, compared to subjects without diabetes, presented greater improvements in executive functions (beta = 0.33 vs. beta = 0.08, P = 0.032) and displayed a higher MedDiet adherence (12.6 points vs. 11.6 points, P = 0.046).</p>Conclusions: Although both metformin and MedDiet interventions are good candidates for future cognitive decline preventive studies, a higher adherence to the MedDiet could even outweigh the potential neuroprotective effects of metformin in subjects with diabetes.</p>
Thematic Areas: Saúde coletiva Nutrition and dietetics Nutrition & dietetics Nutrição Medicina i Interdisciplinar Food science Endocrinology, diabetes and metabolism Educação física
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: jordi.salas@urv.cat nancy.babio@urv.cat
Author identifier: 0000-0003-2700-7459 0000-0003-3527-5277
Record's date: 2024-07-27
Papper version: info:eu-repo/semantics/publishedVersion
Link to the original source: https://www.frontiersin.org/articles/10.3389/fnut.2021.742586/full
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Papper original source: Front Nutr. 8
APA: Soldevila-Domenech, Natalia; Cuenca-Royo, Aida; Babio, Nancy; Forcano, Laura; Nishi, Stephanie; Vintro-Alcaraz, Cristina; Gomez-Martinez, Carlos; Jime (2021). Metformin Use and Cognitive Function in Older Adults With Type 2 Diabetes Following a Mediterranean Diet Intervention. Front Nutr, 8(), -. DOI: 10.3389/fnut.2021.742586
Article's DOI: 10.3389/fnut.2021.742586
Entity: Universitat Rovira i Virgili
Journal publication year: 2021
Publication Type: Journal Publications
Repositori URV