Cognitive Disorders
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Objective To compare the risk of dementia associated with sodium-glucose cotransporter-2 (SGLT-2) inhibitors versus dipeptidyl peptidase-4 (DPP-4) inhibitors in adults aged 40-69 years with type 2 diabetes. Design Population based cohort study. Setting Korean National Health Insurance Service data, 2013-21. Participants 110 885 propensity score matched pairs of adults with type 2 diabetes aged 40-69 years who were initiators of either an SGLT-2 inhibitor or a DPP-4 inhibitor. Main outcome measures The primary outcome was new onset dementia. Secondary outcomes were dementia requiring drug treatment and individual types of dementia, including Alzheimer’s disease and vascular dementia. Control outcomes were genital infections (positive), and osteoarthritis related clinical encounters and cataract surgery (negative). Hazard ratios and 95% confidence intervals (CIs) were estimated using Cox models. Follow-up time stratified analyses (>2 years and ≤2 years) and subgroup analyses by age, sex, concomitant use of…
The life expectancy of people with multiple sclerosis (MS) has increased, yet we have noted that development of a typical Alzheimer disease dementia syndrome is uncommon. We hypothesized that Alzheim...
Objective: Amphetamine prescribing has increased in the United States in recent years. Previous research identified an increased risk of incident psychosis with prescription amphetamines. The purpose of this study was to examine the impact of dose levels of prescription amphetamines on the risk of this rare but serious adverse outcome. Methods: A case-control study using electronic health records was conducted to compare the odds of incident psychosis or mania with past-month exposure to prescription amphetamines. Case subjects were patients ages 16–35 hospitalized at McLean Hospital for incident psychosis or mania between 2005 and 2019. Control subjects were patients with an initial psychiatric hospitalization for other reasons, most commonly depression and/or anxiety. Amphetamine doses were converted to dextroamphetamine equivalents and divided into terciles. Secondary analyses evaluated the odds of psychosis or mania with methylphenidate use. Results: Among 1,374 case subjects and 2,748 control subjects, the…
Background and ObjectivesLittle is known regarding the cost-effectiveness of lecanemab (Leqembi), a monoclonal antibody approved by the US Food and Drug Administration in January 2023 for the treatment of mild cognitive impairment (MCI) or mild dementia ...
Treatment of Alzheimer's disease by targeting the antiamyloid beta (Aβ) peptide with immunotherapy has led to Food and Drug Administration approval of several new Aβ monoclonal antibodies. These approvals have come with restrictions, but the uptake of these new therapies in the clinic is expected to increase rapidly, at least in the USA. Hailed as a “breakthrough” by some, there has been stiff countercommentary questioning both safety and efficacy. The authors of this piece have been among those most concerned about the wisdom of releasing these drugs for clinical use. We note that the debate has been thus far largely confined to the clinical literature. With this Social Issues commentary, the authors hope to bring the basic science research community into the discussion. In 2021, despite investing tens of billions of research dollars, the field of Alzheimer's disease (AD) research was struggling. Since the approval of memantine in 2003 and the extension of donepezil for the treatment of severe AD in 2006 (Feldman…
IntroductionAlzheimer’s disease (AD) prevalence has increased in the last century which can be attributed to increased lifespan, but environment is also impo...
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