Scherrer JF, et al. – In this study, researchers compared the risk of incident dementia among patients who initiated treatment with metformin or sulfonylurea in Veterans Health Affairs (VHA) patients with replication in Kaiser Permanente Washington (KPW) patients to assess whether first-choice antidiabetic medications are linked to reduced dementia risk. The cohorts included 75,187 VHA patients and 10,866 KPW patients (aged ≥ 50 years) who initiated monotherapy with metformin or sulfonylurea. Patients were free of dementia diagnoses and any diabetes treatment for 2 years prior to enrollment. According to findings, metformin monotherapy was correlated with a significantly lower risk of dementia in VHA patients, with a comparable point estimate in KPW patients, following adjustment for confounding. In individuals 75 years and older, metformin was not related to dementia risk. The researchers noted inconsistencies with respect to existing epidemiological studies of metformin and incident dementia. Using a related study design in two patient populations that varied in clinical and demographic features the results offered robust proof that metformin use was related to a modestly lower risk of incident dementia.