Do GLP-1 drugs like Ozempic reduce dementia risk?

Recent studies suggest that glucagon-like peptide-1 receptor agonists (GLP-1RAs), including semaglutide (marketed as Ozempic and Wegovy), may reduce the risk of dementia and Alzheimer’s disease through multiple neuroprotective mechanisms.

GLP-1 drugs are currently FDA approved for treating type 2 diabetes and for weight loss in certain patients, and none are approved for preventing or treating dementia. Studies are ongoing to assess how well Ozempic works to delay or slow down Alzheimer’s disease.

How might GLP-1 drugs reduce the risk of dementia?

It is not known how GLP-1 drugs might lower the risk of dementia. It could be due to reducing risk factors that lead to dementia, such as type 2 diabetes, obesity, and cardiovascular disease. Studies have shown that GLP-1 drugs might play a role in pathways associated with Alzheimer’s disease, such as oxidative stress, mitochondrial dysfunction, and inflammation. It is known that GLP-1 receptors are present in neurons and other brain cells.

Alzheimer’s disease is characterized by amyloid-beta accumulation and long-term inflammation in the brain. In animal models, GLP-1 drugs have been shown to reduce amyloid-beta plaques. Impaired cognitive function is also related to insulin resistance, and GLP-1 drugs help improve insulin signaling in the brain. They also reduce the release of pro-inflammatory cytokines (signaling proteins) that can lessen inflammation in the brain.

What is the evidence that GLP-1 drugs may lower the risk of dementia?

• A 2024 cohort study of over 1 million patients with type 2 diabetes in a US nationwide database of electronic health records found that semaglutide was associated with a 70% lower risk of Alzheimer’s disease within a 3-year follow-up period compared to insulin and a 40% risk reduction relative to other GLP-1 drugs.
• A 2025 cohort study of about 200,000 people in the US Department of Veterans Affairs database with diabetes who started GLP-1 medication found that compared to other treatments, GLP-1 drugs were associated with a lower risk of neurocognitive disorders (including Alzheimer’s disease).
• A 2024 University of Oxford analysis of about 100,000 US patients with type 2 diabetes reported a 48% lower dementia risk in semaglutide users versus sitagliptin (Januvia) over one year.
• A 2025 analysis found that GLP-1 drugs did not have any effect on cognitive performance in the short-term (over several months), but long-term studies that followed patients for up to 3.8 years did show a reduced risk of dementia for semaglutide compared to placebo.

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Summary

Current evidence supports GLP-1RAs as a promising strategy for dementia risk reduction, particularly in patients with type 2 diabetes. Animal studies demonstrate benefits on amyloid clearance, neuroinflammation, and insulin signaling, while observational data show robust epidemiological associations. Long-term randomized-controlled trials in non-diabetic cohorts are needed to understand the relationship between GLP-1 drugs and dementia risk better.