SGLT2 inhibitors may delay cognitive impairment in elderly patients with heart failure

1. In elderly patients 65 years of age or older with heart failure with reduced ejection fraction (HFrEF), regular use of sodium-glucose cotransporter 2 inhibitor (SGLT2i) was associated with improved cognitive function after 6 months as defined by the Mini-Mental State Examination (MMSE). 

Evidence Rating Level: 2 (Good)

Heart failure and cognitive impairment are two frequently co-occurring conditions, yet few investigations have been made into the efficacy of first-line heart failure drugs on cognitive function. Indeed, while SGLT2is have been shown to have mortality benefit in patients with HFrEF, the effects of SGLTis on cognitive function in such patients has not been investigated. This prospective cohort study therefore sought to assess the efficacy of SGLTis on cognitive impairment in elderly patients with HFrEF. 113 elderly patients (mean age, 73.06 ± 5.82 years, 67.9% male) from a single centre in China with HFrEF with cognitive impairment as determined by an MMSE score of <27 were included in this study. 59 patients did not receive SGLT2i while 54 patients received SGLT2i (baseline MMSE, 20.03 ± 1.50 vs 20.19 ± 1.92 (P = 0.640)). After 6 months of follow-up, the MMSE of the group receiving SGLT2is was significantly greater (19.78 ± 1.99 vs 22.28 ± 1.76 (P < 0.05)). Overall, this study found that among elderly patients with HFrEF and cognitive impairment, regular use of SGLT2is over 6 months was associated with improvement in cognitive function. 

Click to read the study in BMC Cardiovascular Disorders

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