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Alzheimer's Association International Conference 2026

July 12-15, 2026 | London, United Kingdom, and Online

5480

Incident Dementia By Diabetes Drug Class In Older Adults With Type 2 Diabetes

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Poster Presenter

Gwen Aubrac

Authors

Gwen Aubrac, Rafeya Raquib, Minh Le, Andrew Stokes

Affiliations

Boston University School of Public Health, Department of Epidemiology, Boston University School of Public Health, Department of Global Health

Part of Topic

Video

Comparative Risk of Dementia for GLP-1 Agonists vs Other Diabetes Treatments in Older Adults With Type 2 Diabetes: A Target Trial Emulation

Introduction

- 6 million adults in the US lived with dementia in 2020 and expect 1 million incident cases by 20601

- Limited pharmacological treatments, but modifiable risk factors including diabetes, obesity, and cardiovascular diseases2

- Semaglutide (GLP-1 agonist) and tirzepatide (dual GLP-1/GIP agonist) approved for diabetes and weight management and shown to be superior to older-generation drugs3-6

- Evoke trials found no benefit of oral semaglutide in early disease, but potential of more potent formulations for primary prevention remains unclear

- Given recent approval, need for evidence on potential of these drugs for dementia prevention using recent data

Objective: Compare the risk of incident all-cause dementia in new users of GLP-1 agonists (semaglutide or tirzepatide) vs SGLT2 inhibitors, DPP4 inhibitors, and sulfonylureas

Methods

Data source: Komodo Health, a US national claims data source containing longitudinal information on medical encounters, pharmaceutical fills, and socio-demographic information

Study period: May 1st, 2022, to December 31st, 2025

Results

-Semaglutide and tirzepatide users tend to be younger, female, White, on commercial insurance, and have higher BMI at baseline

-Semaglutide and tirzepatide found to be protective for dementia compared with SGLT2, DPP4, and sulfonylureas (results consistent in sensitivity analyses)

-Strongest compared with DPP4, but residual confounding after IPTW for that group

Conclusions

-Protective association between use of semaglutide/tirzepatide compared with other diabetes treatments in patients over 60 with T2D and overweight or obesity

-Results support the potential of these medications for primary prevention of dementia in patients with modifiable risk factors

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