Pioglitazone use may help reduce dementia risk in people with type 2 diabetes, claims new study

New research suggests that pioglitazone - a drug used to treat type 2 diabetes may help reduce the risk of dementia.

Pioglitazone, a drug sold under the brand name Actos, is prescribed to treat patients with type 2 diabetes. Diabetes is one of the known risk factors for dementia and people with type 2 diabetes have double the risk of developing diagnosed compared to those without it.

What is dementia?

Dementia is a general term used to describe a group of symptoms including loss of memory, language, problem-solving skills, and other social abilities that are severe enough to interfere with day-to-day functions.

Symptoms of dementia

Some of the common signs and symptoms are as follows:

• Memory loss
• Difficulty in communication
• Difficulty in reading and writing
• Issues with visual and spatial comprehension
• Difficulty in reasoning or problem-solving
• Difficulty in planning and organising
• Difficulty in coordination and motor functioning
• Confusion and disorientation

Those diagnosed with dementia can also experience psychological effects like change in personality, anxiety, depression, delusions or paranoia, and more.

Details about the research

A recent research published in the journal Neurology studied the effects of pioglitazone in reducing the risk of dementia in type 2 patients.

The research led by Dr. Eosu Kim of Yonsei University in South Korea studied a group of 91,218 people who were newly diagnosed with type 2 diabetes that did not have dementia. Out of this number, 3,467 received pioglitazone.

Over a 10-year period, the researchers discovered that approximately eight percent of those taking pioglitazone developed dementia, compared to 10 percent of those who did not take the medication.

After taking into consideration other risk factors for dementia, such as high blood pressure, smoking, and physical activity, the researchers found that people who took pioglitazone were 16 percent less likely to develop dementia. The risk was reduced by 54 percent and 43 percent, respectively, among those with a history of ischemic heart disease (also called cardiac ischemia, reduces the heart muscle's ability to pump blood) or stroke.

The researchers also stated that the longer people took pioglitazone, the stronger the effects to reduce dementia seemed.

In addition, researchers reported that the longer people took pioglitazone, the stronger the dementia risk reduction appeared to be. They also added that people who took pioglitazone were also less likely to have a stroke during the study period.

The link between diabetes and dementia

Experts said that Pioglitazone (Actos) is associated with a lower risk of dementia in diabetes patients, particularly in those with a history of stroke or ischemic heart disease. The drug also lowers the risk of primary and recurrent strokes.

According to the study, people with newly diagnosed type 2 diabetes who took pioglitazone to regulate their blood sugar were less likely to develop dementia later than those who did not take the drug.

However, researchers also said they are unsure whether it's the drug itself that seems to reduce dementia risk or whether it is effective because it helps to improve the symptoms of type 2 diabetes which is associated with it.

This medicine may be an opportunity for early intervention as dementia develops for years before its diagnosis.

"Since dementia develops for years before diagnosis, there may be an opportunity for intervening before it progresses. These results may suggest that we could use a personalized approach to preventing dementia in people with diabetes in the case that they have a history of ischemic heart disease or stroke," Dr. Eosu Kim, of Yonsei University in Seoul, Republic of Korea, said in a press release.

"Although confirmatory studies should be conducted to establish the use of pioglitazone for dementia control, clinicians could consider this drug as a first choice when their newly diagnosed diabetic patients are older and have memory complaints and a history of ischemic illnesses," he added.

"The association found here is very interesting; however, it does not prove that pioglitazone is actually driving the reduced risk. We need large, randomized controlled trials on the right population to evaluate the true benefit," remarked Dr. Keren Zhou, an endocrinologist at Cleveland Clinic in Ohio, who was not involved in the research.

"I would argue that it's premature to begin to switch patients with type 2 diabetes to pioglitazone based on these findings," she added.

This study comes at a time when Hollywood actor Bruce Willis has been diagnosed with frontotemporal dementia—an untreatable condition which leads to loss of brain tissues in frontal and temporal lobes. It causes problems with behaviour and language of a patient.