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GLP-1 RAs, SGLT2 Inhibitors May Reduce Risk for Alzheimer Disease, Dementia in T2DM

Medically reviewed by Carmen Pope, BPharm. Last updated on April 17, 2025.

By Elana Gotkine HealthDay Reporter

THURSDAY, April 17, 2025 -- Both glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) are associated with a reduced risk for Alzheimer disease and related dementias (ADRDs) among people with type 2 diabetes (T2D), according to a study published online April 7 in JAMA Neurology.

Huilin Tang, Ph.D., from the University of Florida College of Pharmacy in Gainesville, and colleagues examined the risk for ADRDs associated with GLP-1 RAs and SGLT2is in people with T2D in a target trial emulation study using electronic health record data. There were 396,963 eligible patients with T2D, of whom 33,858 were included in the GLP-1 RA versus the other glucose-lowering drug (GLD) cohort; 34,185 in the SGLT2i versus the other GLD cohort; and 24,117 in the GLP-1 RA versus SGLT2i cohort.

The researchers found that in inverse probability of treatment weighting-weighted cohorts, the incidence rate of ADRD was lower in GLP-1 RA initiators versus other GLD initiators and in SGLT2i initiators versus other GLD initiators, yielding hazard ratios of 0.67 and 0.57, respectively. No significant difference was seen between GLP-1 RAs and SGLT2is.

"These results support the potential neuroprotections of GLP-1 RAs and SGLT2is and highlight their possible role in ADRD prevention strategies. The comparable association between GLP-1 RAs and SGLT2is provides flexibility in treatment choices while potentially offering cognitive benefits," the authors write.

Several authors disclosed ties to the pharmaceutical and medical technology industries.

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