Diabetes drug semaglutide shows promise in reducing dementia risk

Researchers at the Case Western Reserve School of Medicine have found that semaglutide, a popular diabetes and weight-loss drug, may lower the risk of dementia in people with type 2 diabetes (T2D).

Dementia, a condition that slowly makes it harder for people to remember things and think clearly, occurs when brain cells are damaged and their connections stop working properly. This damage, which worsens over time, can be caused by various modifiable factors, including obesity, T2D, cardiovascular diseases, traumatic brain injury and stroke.

According to the National Institutes of Health, more than 6 million people in the United States are diagnosed with dementia, and it causes more than 100,000 deaths each year. Encouragingly, research indicates that 45% of dementia cases could be prevented by addressing modifiable risk factors.

The study, published today in the Journal of Alzheimer's Disease (DOI 10.1177/13872877251351329), suggests T2D patients taking semaglutide had a significantly lower risk of developing dementia compared to other antidiabetic medications. These results were more profound in women and older adults.

Semaglutide, a glucagon-like peptide receptor (GLP-1R) molecule that decreases hunger and helps regulate blood sugar in T2D, is also the active component in the diabetes and weight-loss drugs Wegovy and Ozempic. Semaglutide has shown a broad range of benefits, including reductions in cardiovascular diseases.

The research team-led by biomedical informatics professor Rong Xu-analyzed three years of electronic records of nearly 1.7 million T2D patients nationally. The researchers used a statistical approach that mimics a randomized clinical trial.

They found patients prescribed semaglutide had a significantly lower risk for Alzheimer's disease-related dementia, compared to those who had taken any of seven other anti-diabetic medications, including other types of GLP-1R-targeting medications.

"There is no cure or effective treatment for dementia, so this new study provides real-world evidence for its potential impact on preventing or slowing dementia development among at-high risk population," said Xu, who also directs the School of Medicine's Center for AI in Drug Discovery and is a member of the Cancer Genomics Epigenomics Program at the Case Comprehensive Cancer Center.

Although their findings potentially support the idea that semaglutide could prevent dementia, the study's limitations restrict the researchers from making firm causal conclusions, she said.

Our results indicate that research into semaglutide's use for dementia prevention will need to be further investigated through randomized clinical trials."

Rong Xu

Source:
Journal reference:

Wang, W., et al. (2025). Associations of semaglutide with Alzheimer’s disease-related dementias in patients with type 2 diabetes: A real-world target trial emulation study. Journal of Alzheimer’s Disease. doi.org/10.1177/13872877251351329.

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