Dementia Risk Does Not Differ With GLP-1 RAs, DPP4is for Seniors With T2DM
By Elana Gotkine HealthDay Reporter
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MONDAY, July 21, 2025 -- For older adults with diabetes, there is no clear evidence to suggest that the incidence of dementia differs for those using glucagon-like peptide 1 receptor agonists (GLP-1 RAs) versus dipeptidyl peptidase-4 inhibitors (DPP4is), according to a study published online July 22 in the Annals of Internal Medicine.
Kosuke Inoue, M.D., Ph.D., from Kyoto University in Japan, and colleagues compared the effect of GLP-1 RAs to DPP4is as second-line therapy for type 2 diabetes on the risk for dementia in a target trial emulation. Participants included Medicare fee-for-service beneficiaries aged 66 years or older who used metformin and initiated GLP-1 RAs or DPP4is between January 2017 and December 2018.
The analyses included 2,418 patients initiating GLP-1 RAs and 4,836 propensity score-matched patients initiating DPP4is (mean age, 71 years). The researchers found that during a median follow-up of 1.9 years, the outcome of dementia onset occurred in 96 and 217 patients in the GLP-1 RA and DPP4i groups, respectively. At 30 months, the estimated risk difference was −0.93 (95 percent confidence interval, −2.33 to 0.23) percentage points and the estimated risk ratio was 0.83 (95 percent confidence interval, 0.61 to 1.05). For those younger than 75 years and those 75 years and older, the estimated risk ratios were 0.64 (95 percent confidence interval, 0.46 to 0.93) and 1.22 (95 percent confidence interval, 0.74 to 1.66), respectively.
"Although there was a signal of lower incidence of dementia with GLP-1 RAs than with DPP4is among adults younger than 75 years, the causal relationship remains unclear," the authors write.
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Posted July 2025
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