Effect of SGLT2 inhibitors on cognitive function in elderly patients with heart failure: a comparative prospective study
A HacilAbstract
Background
Heart failure (HF) is common in elderly populations and linked with cognitive impairment, which worsens outcomes and quality of life. Sodium-glucose co-transporter 2 inhibitors (SGLT2i), known for their cardiovascular and renal benefits, may also have neuroprotective effects, but clinical evidence on cognition in elderly HF patients remains limited.
Methods
This prospective study examined cognitive trajectories using Mini-Mental State Examination (MMSE) scores over 24 months in elderly HF patients treated with SGLT2i compared to a control group. Adjusted linear mixed models accounted for confounders including age, sex, comorbidities, and cardiac function.
Results
496 patients (260 treated with SGLT2i, 236 controls) were included. Over 24 months, the SGLT2i group demonstrated significantly greater improvement in MMSE scores compared to controls. The mixed model showed a significant treatment-by-time interaction (p<0.001), indicating slower cognitive decline in the SGLT2i group. The findings suggest a potential protective effect of SGLT2i on cognition in elderly HF patients.
Conclusions
SGLT2i therapy may mitigate cognitive decline in elderly patients with HF. These results support further exploration of SGLT2i’s neuroprotective potential in this high-risk population.