- The glucose-lowering glucagon-like peptide-1 (GLP-1) receptor agonist dulaglutide could reduce cognitive impairment in people age ≥50 years with type 2 diabetes (T2D).
Why this matters
- Diabetes is an independent risk factor for cognitive impairment.
- Data for 8828 participants age ≥50 years in REWIND, a randomized, double-blind, placebo-controlled, multicenter international trial of patients with T2D with HbA1c ≤9.5% and additional cardiovascular risk factors.
- Cognitive function was assessed at baseline and at 2-year, 5-year, and end-of-study visits.
- Assessments: Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST).
- Funding: Eli Lilly and Company.
- Incidence of primary cognitive outcome (first occurrence of follow-up score on MoCA or DSST of ≥1.5 standard deviations below baseline mean score in participant's country):
- 4.05 per 100 patient-years with dulaglutide vs
- 4.35 per 100 patient-years with placebo.
- Adjusted (a)HR, 0.93 (P=.11).
- After post hoc adjustment for baseline MoCA and DSST standardized scores, dulaglutide group had a 14% lower hazard of substantive cognitive impairment (SCI) vs those assigned to placebo (aHR, 0.86; P=.0018).
- Exploratory data.
- 2-year interval between baseline and first subsequent test.
- Adjustment of SCI outcome for baseline scores was not prespecified.
- Only 2 cognitive tests used.
- No prestudy cognitive status information.