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. 2022 Nov 17;14(22):8927-8943.
doi: 10.18632/aging.204393. Epub 2022 Nov 17.

The potential benefit of metformin to reduce delirium risk and mortality: a retrospective cohort study

Takehiko Yamanashi  1   2   3 , Zoe-Ella Em Anderson  2 , Manisha Modukuri  2 , Gloria Chang  2 , Tammy Tran  2 , Pedro S Marra  2 , Nadia E Wahba  2 , Kaitlyn J Crutchley  2 , Eleanor J Sullivan  2 , Sydney S Jellison  2 , Katie R Comp  2 , Cade C Akers  2 , Alissa A Meyer  2 , Sangil Lee  4 , Masaaki Iwata  3 , Hyunkeun R Cho  5 , Eri Shinozaki  6 , Gen Shinozaki  1   2
Affiliations

The potential benefit of metformin to reduce delirium risk and mortality: a retrospective cohort study

Takehiko Yamanashi et al. Aging (Albany NY). .

Abstract

Purpose: Metformin has been reported to improve age-related disorders, including dementia, and to lower mortality. This study was conducted to investigate whether metformin use lower delirium risk, as well as long-term mortality.

Methods: In this retrospective cohort study, previously recruited 1,404 subjects were analyzed. The relationship between metformin use and delirium, and the relationship between metformin use and 3-year mortality were investigated.

Main findings: 242 subjects were categorized into a type 2 diabetes mellitus (DM)-without-metformin group, and 264 subjects were categorized into a DM-with-metformin group. Prevalence of delirium was 36.0% in the DM-without-metformin group, and 29.2% in the DM-with-metformin group. A history of metformin use reduced the risk of delirium in patients with DM (OR, 0.50 [95% CI, 0.32 to 0.79]) after controlling for confounding factors. The 3-year mortality in the DM-without-metformin group (survival rate, 0.595 [95% CI, 0.512 to 0.669]) was higher than in the DM-with-metformin group (survival rate, 0.695 [95% CI, 0.604 to 0.770]) (p=0.035). A history of metformin use decreased the risk of 3-year mortality after adjustment for confounding factors (HR, 0.69 [95% CI, 0.48 to 0.98]).

Conclusions: Metformin use may lower the risk of delirium and mortality in DM patients.

Keywords: aging; delirium; diabetes mellitus; metformin; mortality.

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Conflict of interest statement

CONFLICTS OF INTEREST: Gen Shinozaki is co-founder of Predelix Medical LLC and has pending patents as follows: “Non-invasive device for predicting and screening delirium”, PCT application no. PCT/US2016/064937 and US provisional patent no. 62/263,325; “Prediction of patient outcomes with a novel electroencephalography device”, US provisional patent no. 62/829,411; “Epigenetic Biomarker of Delirium Risk” in the PCT Application No. PCT/US19/51276, and in U.S. Provisional Patent No. 62/731,599. All other authors have declared that no conflict of interest exists.

Figures

Figure 1
Figure 1
Prevalence of delirium by comparing three patient groups based on their DM status and history of metformin use. The Chi-square test corrected by Holm method showed significant difference between non-DM group and DM-without-metformin group (p=0.048).
Figure 2
Figure 2
Kaplan-Meier cumulative survival curve over 3 years based on the three-group comparison.
See this image and copyright information in PMC

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