GLP-1 drugsHumans

SGLT2 inhibitors link to lower dementia risk than GLP-1 drugs

Older adults taking GLP-1 agonists showed higher risks of Alzheimer's disease (RR 1.33) and all-cause mortality (RR 1.11) than those on SGLT2 inhibitors.

Diabetes & Vascular Disease Research4 Oct 2026, 08:20 BST

In a retrospective study of adults aged 60 and older with type 2 diabetes, researchers compared outcomes between sodium-glucose cotransporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Using the TriNetX US Collaborative Network from 2014 to 2020, they examined propensity-score matched cohorts of 56,211 patients per group who were also receiving metformin.

Over five years, GLP-1 RA use was associated with higher risks of Alzheimer's disease (RR 1.33, 95% CI 1.18-1.48), vascular dementia (RR 1.56, 95% CI 1.39-1.76), other dementia (RR 1.33, 95% CI 1.21-1.47), and all-cause mortality (RR 1.11, 95% CI 1.08-1.15) compared with SGLT2is. GLP-1 RA users also initiated dementia-related medications more frequently. Risks of NSTEMI and STEMI did not differ significantly between the two groups.

Why it matters

Both drug classes exert pleiotropic effects beyond glycemic control, making their comparative effects on dementia and survival relevant to aging-related clinical decisions.

Caveats

The study is observational and retrospective, and the authors note that these findings are hypothesis-generating and require confirmation in prospective trials.