Association Between Metformin Use and Cognitive and Physical Function in People Living with HIV and Diabetes

Cognitive impairment and frailty are common problems with higher rates among older people living with HIV. Metformin is a diabetes medication that has demonstrated benefits for cognition and physical function among older individuals who do not have HIV. To study the effects of metformin in the setting of HIV, investigators compared cognition and frailty, including measures of physical function (e.g., gait speed and grip strength) between people living with HIV and diabetes who were and were not prescribed metformin in study A5322 (HAILO observational study). This study is the first to examine the relationship between metformin use and cognitive or physical functional outcomes in an HIV cohort.

Researchers did not find any significant associations between metformin use, frailty, physical, or cognitive function in either unadjusted or adjusted cross-sectional, longitudinal, or time-to-event analyses. This study was limited by a small sample size, restriction to people with diabetes, and lack of randomization to metformin. As with any observational research, there was the potential for unmeasured confounding and these findings reflect the need for a randomized clinical trial to determine whether metformin has beneficial effects on cognitive or physical function among all older people living with HIV regardless of whether they have diabetes.

Masters, M. C., Granche, J., Yang, J., Overton, E. T., Letendre, S., Koletar, S. L., Rubin, L. H., Brown, T. T., Tassiopoulos, K., Erlandson, K. M., & Palella, F. (2023). Association Between Metformin Use and Cognitive and Physical Function in Persons with HIV and Diabetes. AIDS research and human retroviruses, 10.1089/AID.2022.0129. Advance online publication.