How do you counsel non-diabetic patients who wish to start metformin to reduce the risk of developing dementia?

There have been some interesting observational studies evaluating the reduction of cognitive decline in patients with type 2 DM. First, they are all in patients WITH diabetes, so not yet generalizable to patients without DM. Second, they are observational trials, which means that they cannot adjust ...

Multi-domain lifestyle interventions, such as those used in the FINGER trial, have stronger evidence for reducing and partially reversing cognitive impairment, are safe, and have co-benefits to all organ systems compared to metformin. I tell patients to focus on those instead, and that Metformin dat...