THURSDAY, Feb. 16, 2023 (HealthDay News) — For patients with diabetes mellitus (DM), pioglitazone use is associated with a reduced risk for dementia, especially in those with a history of ischemic heart disease or stroke, according to a study published online Feb. 15 in Neurology.

Junghee Ha, M.D., Ph.D., from the Yonsei University College of Medicine in Seoul, South Korea, and colleagues examined the effects of pioglitazone use on dementia in patients with new-onset type 2 DM using data from the Korean National Health Insurance Service DM cohort (2002 to 2017). The extent to which incident stroke affects the association between pioglitazone use and dementia was assessed.

The researchers found that compared with nonuse, pioglitazone use was associated with a reduced risk for dementia (adjusted hazard ratio, 0.84); patients with a history of ischemic heart disease or stroke before DM onset had a greater risk reduction in dementia (adjusted hazard ratios, 0.46 and 0.57, respectively). Pioglitazone use was also associated with a reduced risk for stroke incidence (adjusted hazard ratio, 0.81). However, a lowered risk for dementia was not seen when stroke developed during the observation period of pioglitazone use.

“These results provide valuable information on who could potentially benefit from pioglitazone use for prevention of dementia,” a coauthor said in a statement. “In some previous studies of people with dementia or at risk of cognitive decline who did not have diabetes, pioglitazone did not show any protection against dementia, so it’s likely that a critical factor affecting the effectiveness is the presence of diabetes.”

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