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Abstract
Aim
The aim of this study was to assess whether the inhibitor of sodium-glucose cotransporter-2 (SGLT2) empagliflozin improves cognitive impairment in frail older adults with diabetes mellitus (DM) and Heart Failure with Preserved Ejection Fraction (HFpEF).
Methods
We designed a prospective study to assess cognitive and physical function in consecutive frail older adults with DM and HFpEF, comparing the effects of empagliflozin, metformin, and insulin.
Results
A total of 162 frail elders with HFpEF and DM successfully completed the study. The Montreal Cognitive Assessment (MoCA) score was measured at baseline and after 1-month: 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: 0.26) in the metformin group; 19. 00±3.71 vs. 19.1±3.56 (p: 0.81) in the insulin group. A multivariate regression analysis confirmed the beneficial effects of empagliflozin. Additionally, we observed a marked amelioration of physical impairment, assessed by the 5-meter gait speed test, in the empagliflozin and in the metformin arms, but not in patients receiving insulin.
Conclusions
To the best of our knowledge, this is the first study to show significant beneficial effects of empagliflozin treatment on cognitive and physical impairment in frail subjects with HFpEF and DM.
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Details
1 ASL AV , Avellino , Italy
2 ALBERT EINSTEIN COLLEGE OF MEDICINE , New York, NY , USA