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Commentary
Adult nursing
Increased risk of dementia in older adults starting sulfonylurea: taking sulfonylurea off the list
  1. Danielle Pessoa Lima1,2,
  2. Lucas Tadeu Rocha Santos2
  1. 1School of Medicine, Universidade de Fortaleza Centro de Ciencias da Saude, Fortaleza, Brazil
  2. 2Geriatrics, Universidade Federal do Ceará Hospital Universitário Walter Cantídio, Fortaleza, Brazil
  1. Correspondence to Dr Danielle Pessoa Lima, School of Medicine, Universidade de Fortaleza Centro de Ciencias da Saude, Fortaleza 60811905, Brazil; dra.daniellelima{at}gmail.com

https://doi.org/10.1136/ebnurs-2023-103791

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    Commentary on: Wu CY, Iskander C, Wang C, et al. Association of sulfonylureas with the risk of dementia: A population-based cohort study. J Am Geriatr Soc. 2023; 71:3059–70.

    Implications for practice and research

    • Unless contraindicated, dipeptidyl peptidase 4 inhibitors (DPP-4i) should be used as first-line choice in older adults with type 2 diabetes in preference to sulfonylurea due to increased risk of dementia.

    • Prospective studies are needed to ascertain if the use of sulfonylurea by older adult patients causes higher risk of developing dementia.

    Context

    Diabetes is already known as a risk factor for developing dementia. Multiple factors contribute to this association: presence of microvascular and macrovascular complications, chronic inflammation, hyperglycaemia, hypoglycaemia and hyperinsulinemia.1

    Older adult patients often present with multimorbidities, polypharmacy, malnutrition, sarcopenia, longer duration of diabetes and renal and hepatic dysfunction. Furthermore, low education level, high blood pressure, dyslipidemia, obstructive sleep apnea syndrome, physical inactivity, depression, …

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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.