Effects of vildagliptin, a DPP-4 inhibitor, in elderly diabetic patients with mild cognitive impairment

Introduction: There is an unclear association between type 2 diabetes and mild cognitive impairment in the elderly. Both diseases are more prevalent in the older adults compared to the younger counterpart. Some antidiabetic drugs seem to influence positively the evolution of mild cognitive impairment. This retrospective study investigated the effect of vildagliptin, an inhibitor of the enzyme dipeptidyl peptidase-4 (DPP-4), on the cognitive functioning of elderly diabetic patients with mild cognitive impairment (MCI) documented at mini mental state examination (MMSE). Methods: We included 60 diabetic elderly people which were divided in 2 groups: Group A, 30 patients with HbA(1)c (glycated hemoglobin) <= 7.5% and treated with metformin, and Group B, 30 patients with HbA(1)c > 7.5%, and treated with metformin plus vildagliptin. We collected data on MMSE, fasting plasma glucose (FPG) and HbA(1)c at baseline and after 180 +/- 10 days from the beginning of treatment. Results: The two groups exhibited significantly different values in FPG (P < 0.05) and HbA(1)c (P < 0.01) at baseline, and in MMSE score (P < 0.001) after treatment. The intragroup comparison showed a significant (P < 0.05) reduction in MMSE score in group A, and in HbA1c (P = 0.01) in group B. Conclusion: Vildagliptin in addition to metformin resulted in the maintenance of MMSE score, showing a protecting role on cognitive functioning compared to the metformin only group.