Comparative effectiveness of sodium‐glucose cotransporter‐2 inhibitors and glucagon‐like peptide‐1 receptor agonists for incident dementia: A retrospective multicohort study
Authors' conclusion
SGLT2i use was not associated with increased risk of dementia compared with GLP-1RAs in patients with T2DM. Further research is warranted to explore the effects of (newer) incretin-based (co-)agonists on cognitive outcomes.
Study context
- Population
- Adults with T2D on metformin initiating GLP-1 RAs or SGLT2i, TriNetX electronic health records (1 April 2013 to 31 December 2019)matched cohort
- Participants
- 16,271 vs 16,271
- Exposure
- GLP-1 RA vs SGLT2i
- GLP-1 RAsn = 16,271
- SGLT2in = 16,271
- Outcome
- All-cause dementia
- Follow-up
- median 6.3-year follow-up
Methodological detailsmulticohort, 1:1 propensity score-matched, electronic health records (TriNetX)
- Multicohort
- 1:1 propensity score-matched
- Electronic health records (TriNetX)
Main finding
As reported in the abstract
Hazard ratio
1.01
95% CI 0.90–1.13
Events by group
GLP-1 RAs
581
events
SGLT2i
572
events
Between GLP-1 RAs and SGLT2i
HR 1.01 (95% CI 0.90–1.13)
Observational data: associations, not effects.
Secondary outcomes
Vascular and Alzheimer's dementia
- No significant differences in vascular or Alzheimer's dementia
Subgroup analyses
- Subgroup analyses confirmed these findings
Original publication
Comparative effectiveness of sodium‐glucose cotransporter‐2 inhibitors and glucagon‐like peptide‐1 receptor agonists for incident dementia: A retrospective multicohort study. Diabetes Obes Metab. Published 27 November 2025. doi:10.
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