920-P: Sodium–Glucose Cotransporter 2 Inhibitor Use and Risk of Dementia and Parkinson’s disease among Patients with Type 2 Diabetes—A Longitudinal, Nationwide, Population-Based Cohort Study

The efficacy of sodium-glucose cotransporter 2 inhibitor (SGLT2i) in neurologic disorders is not well-established. This study aimed to investigate the association of SGLT2i use with risks of incident dementia and Parkinson’s disease (PD) in patient with type 2 diabetes. Subjects aged ≥ 40 years, diagnosed with type 2 diabetes, and who started antidiabetic drugs from 1 September 2014 and 31 December 2019 were evaluated, using the National Health Insurance Service Database. Propensity score matching (1:1; SGLT2i to other oral antidiabetic drugs [OAD]) produced a cohort of 358,862. Primary outcomes were a composite of dementia from any cause (Alzheimer’s disease [AD], vascular dementia [VaD], and other dementia) and PD. From the 358,862 participants analyzed (mean age, 57.8 years; 57.9% male), 6,837 incident dementia or PD events occurred. Overall, use of SGLT2i was associated with a 22% lower risk for the composite of dementia from any cause and PD than use of other OADs (adjusted HR [aHR], 0.78 [95% CI 0.73─0.83]) with a 6-month lag period. Regarding the individual endpoints, SGLT2i use was associated with reduced risks for AD (aHR, 0.81 [95% CI 0.76─0.87]), VaD (aHR, 0.69 [95% CI 0.60─0.78]), and PD (aHR, 0.80 [95% CI 0.69─0.91]). In this nationwide population-based cohort study, SGLT2i use significantly reduced the risks for dementia and PD in patients with type 2 diabetes independent of various factors including comorbidities and bioclinical parameters.