The effect of SGLT2-I use on cognitive functions in geriatric patients diagnosed with diabetes mellitus

Aim: This study aimed to evaluate cognitive, metabolic, and functional changes in elderly individuals (≥65 years) with type 2 diabetes mellitus who were receiving SGLT2 inhibitors. Material and Method: Elderly patients with type 2 diabetes using SGLT2 inhibitors were compared with non-diabetic peers in a geriatrics outpatient setting. All participants were followed up for 6 months. Cognitive function was assessed by the Mini-Mental State Examination (MMSE); functional status was evaluated using the Barthel Index, Lawton-Brody IADL, POMA, and the 6-meter walk test. Results: Significant improvements were observed in HbA1c, LDL, BMI, and albumin/creatinine ratio in the SGLT2 inhibitor group. While global MMSE scores remained stable, a limited decline was noted in the registration subcomponent. Subgroup analysis showed cognitive stability in those using SGLT2 inhibitors alone, whereas a significant decline in MMSE scores was found in patients using both SGLT2 and DPP-4 inhibitors. Conclusion: In elderly diabetic patients with improved glycemic control and weight loss, the use of SGLT2 inhibitors was not associated with global cognitive decline. These findings suggest that SGLT2 inhibitors may be a cognitively safe treatment option in the elderly and might possess potential neuroprotective effects. Keywords: Cognition disorders, diabetes mellitus, geriatrics, neuroprotective agents, SGLT2 inhibitors