Empagliflozin Improves Cognitive Impairment in Frail Older Adults With Type 2 Diabetes and Heart Failure With Preserved Ejection Fraction

Pasquale Mone; Angela Lombardi; Jessica Gambardella; Antonella Pansini; Gaetano Macina; Maria Morgante; Salvatore Frullone; Gaetano Santulli

doi:10.2337/dc21-2434

Empagliflozin Improves Cognitive Impairment in Frail Older Adults With Type 2 Diabetes and Heart Failure With Preserved Ejection Fraction

Pasquale Mone, Angela Lombardi, Jessica Gambardella, Antonella Pansini, Gaetano Macina, Maria Morgante, Salvatore Frullone, Gaetano Santulli

Medicine

Research output: Contribution to journal › Article › peer-review

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Abstract

OBJECTIVE To assess whether the sodium–glucose cotransporter 2 (SGLT2) inhibitor empagli-flozin improves cognitive impairment in frail older adults with diabetes and heart failure with preserved ejection fraction (HFpEF). RESEARCH DESIGN AND METHODS We designed a prospective study to assess cognitive and physical function in con-secutive frail older adults with diabetes and HFpEF, comparing the effects of empagliflozin, metformin, and insulin. RESULTS A total of 162 frail older adults with HFpEF and diabetes successfully completed the study. Montreal Cognitive Assessment scores at baseline and after 1 month were 19.80 ± 3.77 vs. 22.25 ± 3.27 (P < 0.001) in the empagliflozin group, 19.95 ± 3.81 vs. 20.71 ± 3.56 (P 5 0.26) in the metformin group, and 19.00 ± 3.71 vs. 19.1 ± 3.56 (P 5 0.81) in the insulin group. A multivariable regression analysis confirmed the beneficial effects of empagliflozin. Additionally, we observed a marked amelioration of physical impairment, assessed by the 5-m gait speed test, in the empagliflozin and metformin groups but not in the insulin group. CONCLUSIONS This study is the first to show significant beneficial effects of the SGLT2 inhibitor empagliflozin on cognitive and physical impairment in frail older adults with diabetes and HFpEF.

Original language	English (US)
Pages (from-to)	1247-1251
Number of pages	5
Journal	Diabetes care
Volume	45
Issue number	5
DOIs	https://doi.org/10.2337/dc21-2434
State	Published - May 2022

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Advanced and Specialized Nursing

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10.2337/dc21-2434

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@article{34bd7dca9eb74122a44ac87916948d5c,

title = "Empagliflozin Improves Cognitive Impairment in Frail Older Adults With Type 2 Diabetes and Heart Failure With Preserved Ejection Fraction",

abstract = "OBJECTIVE To assess whether the sodium–glucose cotransporter 2 (SGLT2) inhibitor empagli-flozin improves cognitive impairment in frail older adults with diabetes and heart failure with preserved ejection fraction (HFpEF). RESEARCH DESIGN AND METHODS We designed a prospective study to assess cognitive and physical function in con-secutive frail older adults with diabetes and HFpEF, comparing the effects of empagliflozin, metformin, and insulin. RESULTS A total of 162 frail older adults with HFpEF and diabetes successfully completed the study. Montreal Cognitive Assessment scores at baseline and after 1 month were 19.80 ± 3.77 vs. 22.25 ± 3.27 (P < 0.001) in the empagliflozin group, 19.95 ± 3.81 vs. 20.71 ± 3.56 (P 5 0.26) in the metformin group, and 19.00 ± 3.71 vs. 19.1 ± 3.56 (P 5 0.81) in the insulin group. A multivariable regression analysis confirmed the beneficial effects of empagliflozin. Additionally, we observed a marked amelioration of physical impairment, assessed by the 5-m gait speed test, in the empagliflozin and metformin groups but not in the insulin group. CONCLUSIONS This study is the first to show significant beneficial effects of the SGLT2 inhibitor empagliflozin on cognitive and physical impairment in frail older adults with diabetes and HFpEF.",

author = "Pasquale Mone and Angela Lombardi and Jessica Gambardella and Antonella Pansini and Gaetano Macina and Maria Morgante and Salvatore Frullone and Gaetano Santulli",

note = "Funding Information: Acknowledgments. The authors thank Dr. X. Wang and Dr. F. Varzideh (Albert Einstein College of Medicine, New York, NY) for technical support and helpful discussion. Funding. This study is supported, in part, by the National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases (grants R01-DK123259 and R01-DK033823); National Heart, Lung, and Blood Institute (grants R01-HL146691, R01-HL159062, and T32-HL144456); and National Institute on Aging (grants R56-AG066431) to G.S. The study is also supported by the Irma T. Hirschl and Monique Weill-Caulier Trusts (to G.S.), the Diabetes Action Research and Education Foundation (to G.S.), and by the American Heart Association (AHA-20POST35211151 to J.G.). Publisher Copyright: {\textcopyright} 2022 by the American Diabetes Association.",

year = "2022",

month = may,

doi = "10.2337/dc21-2434",

language = "English (US)",

volume = "45",

pages = "1247--1251",

journal = "Diabetes Care",

issn = "1935-5548",

publisher = "American Diabetes Association Inc.",

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T1 - Empagliflozin Improves Cognitive Impairment in Frail Older Adults With Type 2 Diabetes and Heart Failure With Preserved Ejection Fraction

AU - Mone, Pasquale

AU - Lombardi, Angela

AU - Gambardella, Jessica

AU - Pansini, Antonella

AU - Macina, Gaetano

AU - Morgante, Maria

AU - Frullone, Salvatore

AU - Santulli, Gaetano

N1 - Funding Information: Acknowledgments. The authors thank Dr. X. Wang and Dr. F. Varzideh (Albert Einstein College of Medicine, New York, NY) for technical support and helpful discussion. Funding. This study is supported, in part, by the National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases (grants R01-DK123259 and R01-DK033823); National Heart, Lung, and Blood Institute (grants R01-HL146691, R01-HL159062, and T32-HL144456); and National Institute on Aging (grants R56-AG066431) to G.S. The study is also supported by the Irma T. Hirschl and Monique Weill-Caulier Trusts (to G.S.), the Diabetes Action Research and Education Foundation (to G.S.), and by the American Heart Association (AHA-20POST35211151 to J.G.). Publisher Copyright: © 2022 by the American Diabetes Association.

PY - 2022/5

Y1 - 2022/5

N2 - OBJECTIVE To assess whether the sodium–glucose cotransporter 2 (SGLT2) inhibitor empagli-flozin improves cognitive impairment in frail older adults with diabetes and heart failure with preserved ejection fraction (HFpEF). RESEARCH DESIGN AND METHODS We designed a prospective study to assess cognitive and physical function in con-secutive frail older adults with diabetes and HFpEF, comparing the effects of empagliflozin, metformin, and insulin. RESULTS A total of 162 frail older adults with HFpEF and diabetes successfully completed the study. Montreal Cognitive Assessment scores at baseline and after 1 month were 19.80 ± 3.77 vs. 22.25 ± 3.27 (P < 0.001) in the empagliflozin group, 19.95 ± 3.81 vs. 20.71 ± 3.56 (P 5 0.26) in the metformin group, and 19.00 ± 3.71 vs. 19.1 ± 3.56 (P 5 0.81) in the insulin group. A multivariable regression analysis confirmed the beneficial effects of empagliflozin. Additionally, we observed a marked amelioration of physical impairment, assessed by the 5-m gait speed test, in the empagliflozin and metformin groups but not in the insulin group. CONCLUSIONS This study is the first to show significant beneficial effects of the SGLT2 inhibitor empagliflozin on cognitive and physical impairment in frail older adults with diabetes and HFpEF.

AB - OBJECTIVE To assess whether the sodium–glucose cotransporter 2 (SGLT2) inhibitor empagli-flozin improves cognitive impairment in frail older adults with diabetes and heart failure with preserved ejection fraction (HFpEF). RESEARCH DESIGN AND METHODS We designed a prospective study to assess cognitive and physical function in con-secutive frail older adults with diabetes and HFpEF, comparing the effects of empagliflozin, metformin, and insulin. RESULTS A total of 162 frail older adults with HFpEF and diabetes successfully completed the study. Montreal Cognitive Assessment scores at baseline and after 1 month were 19.80 ± 3.77 vs. 22.25 ± 3.27 (P < 0.001) in the empagliflozin group, 19.95 ± 3.81 vs. 20.71 ± 3.56 (P 5 0.26) in the metformin group, and 19.00 ± 3.71 vs. 19.1 ± 3.56 (P 5 0.81) in the insulin group. A multivariable regression analysis confirmed the beneficial effects of empagliflozin. Additionally, we observed a marked amelioration of physical impairment, assessed by the 5-m gait speed test, in the empagliflozin and metformin groups but not in the insulin group. CONCLUSIONS This study is the first to show significant beneficial effects of the SGLT2 inhibitor empagliflozin on cognitive and physical impairment in frail older adults with diabetes and HFpEF.

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Empagliflozin Improves Cognitive Impairment in Frail Older Adults With Type 2 Diabetes and Heart Failure With Preserved Ejection Fraction

Abstract

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