Objective:

To comprehensively evaluate the effects of different antidiabetic drugs on dementia risk, highlighting the significance of this relationship in diabetes management.

Key Findings:

• Insulin (OR = 0.11, 95% CrI 0.1-0.12), Metformin (OR = 0.79, 95% CrI 0.77-0.81), and Pioglitazone (OR = 0.69, 95% CrI 0.56-0.86) reduced dementia incidence compared to placebo.
• DPP4 inhibitors were associated with a higher incidence of Alzheimer's (OR = 1.78, 95% CrI 1.66-1.91) and Vascular dementia (OR = 2.59, 95% CrI 2.33-2.88) compared to SGLT2 inhibitors.
• Insulin showed the most pronounced efficacy in reducing dementia risk.

Interpretation:

The findings suggest that certain antidiabetic medications may have protective effects against dementia, with insulin being the most effective, indicating a need for further clinical exploration.

Limitations:

• The study is based on existing literature, which may have variability in study design and quality, potentially affecting the reliability of the results.
• Potential publication bias and heterogeneity among studies could skew the findings.

Conclusion:

Insulin is the most effective antidiabetic medication in reducing dementia risk, while SGLT2 inhibitors and GLP1 receptor agonists may also provide benefits for Alzheimer's disease management, warranting further investigation.