Overview

• A global observational study of electronic health records from 2004 to 2024 compared dementia and mortality outcomes in type 2 diabetes patients treated with GLP-1 receptor agonists versus metformin.
• Treatment with GLP-1 receptor agonists was linked to a nearly 50% lower cumulative incidence of dementia, including a 12% reduction in Alzheimer’s disease and a 25% reduction in non-vascular dementia compared to metformin.
• All-cause mortality was almost halved among patients on GLP-1 receptor agonists, with death rates of around 5% versus 9% in the metformin group.
• Unlike metformin’s systemic metabolic benefits, GLP-1 receptor agonists cross the blood-brain barrier to reduce neuroinflammation and oxidative stress, offering direct central nervous system protection.
• The study found no significant effect on vascular dementia, and researchers emphasize that randomized long-term trials are essential before integrating GLP-1 receptor agonists into first-line diabetes care for cognitive protection.