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Dementia

Incretin-Based Drugs May Reduce Dementia Risk in Patients with Type 2 Diabetes

Strategic Insights

— 2 min read

Recent research conducted by investigators at McGill University suggests that incretin-based drugs, namely glucagon-like peptide 1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase 4 (DPP-4) inhibitors, may have neuroprotective effects and be associated with a decreased risk of dementia among patients with type 2 diabetes. Using data from the Clinical Practice Research Datalink from the UK, the researchers formed two new user cohorts of patients at least 50 years of age with type 2 diabetes starting incretin-based drugs or sulfonylureas between 2007 and 2021. The study found that DPP-4 inhibitors were associated with a reduced dementia risk compared with sulfonylureas, and similar associations were observed across dementia subtypes and individual DPP-4 inhibitors molecules.

Key Takeaways:

  • DPP-4 inhibitors, and possibly GLP-1 RAs, were associated with a reduced dementia risk compared with sulfonylureas in patients with type 2 diabetes.
  • The risk reduction increased with cumulative duration of use and dose, but with high uncertainty.
  • The study found statistically significant reductions in dementia risk with DPP-4 inhibitors compared to sulfonylureas, but the association was not as clear for GLP-1 RAs.
  • The researchers used the Clinical Practice Research Datalink from the UK to form two new user cohorts of patients at least 50 years of age with type 2 diabetes starting incretin-based drugs or sulfonylureas between 2007 and 2021.
  • The study included data on 275,144 initiators of DPP-4 inhibitors or sulfonylureas, followed for 750,846 person-years, and 181,215 initiators of GLP-1 RAs or sulfonylureas, followed for 530,415 person-years.
  • The researchers concluded that incretin-based drugs may have neuroprotective effects and be associated with a decreased risk of dementia among patients with type 2 diabetes.

Statistics:

  • 275,144 initiators of DPP-4 inhibitors or sulfonylureas, followed for 750,846 person-years.
  • 181,215 initiators of GLP-1 RAs or sulfonylureas, followed for 530,415 person-years.
  • DPP-4 inhibitors were associated with a reduced dementia risk compared with sulfonylureas (4.4 vs. 5.7 events per 1000 person-years; HR 0.77, 95% CI 0.71-0.85).
  • GLP-1 RAs were associated with a similar reduction in dementia risk compared with sulfonylureas, although with high uncertainty (2.3 vs. 3.1 events per 1000 person-years; HR 0.74, 95% CI 0.46-1.18).

Sources:

  • Incretin-Based Drugs and the Risk of Dementia Among Patients with Type 2 Diabetes. Drug Safety, 2025. Adis Int Ltd, 5 The Warehouse Way, Northcote 0627, Auckland, New Zealand.
  • NewsRx. Researchers at McGill University Report Findings in Type 2 Diabetes (Incretin-Based Drugs and the Risk of Dementia Among Patients with Type 2 Diabetes). Mental Health Weekly Digest. November 3, 2025; p 416.

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