GLP-1 Receptor Agonists Linked to Reduced Dementia and Stroke Risks

A recent study has revealed that the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), particularly semaglutide and tirzepatide, is associated with a significantly lower risk of dementia and ischemic stroke in adults suffering from type 2 diabetes (T2D) and obesity. Conducted by researchers at Chang Gung Memorial Hospital in Taoyuan, Taiwan, the study analyzed data from over 60,000 adults aged 40 and older between 2017 and 2024. The findings were published on July 15, 2025, in JAMA Network Open.

The retrospective cohort study found that patients using GLP-1 RAs demonstrated a 37% reduced risk of developing dementia and a 19% reduced risk of ischemic stroke when compared to individuals taking other antidiabetic medications. These neuroprotective effects were particularly pronounced among older adults, women, and individuals with a body mass index (BMI) ranging from 30 to 40.

According to Dr. Huan-Tang Lin, MD, PhD, the lead author of the study, the findings suggest that GLP-1 RAs could extend their benefits beyond glycemic control to potentially enhance long-term cognitive health and survival outcomes. Dr. Lin emphasized the importance of further clinical trials to confirm these protective effects against neurodegenerative diseases.

The analysis involved propensity-score matching, which ensured that the GLP-1 RA group (30,430 participants) and the 'other antidiabetic drug' group (30,430 participants) were comparable regarding baseline characteristics, including age, sex, and racial demographics. Both groups had a mean age of approximately 58 years and were predominantly white. The study showed that GLP-1 RA users had a hazard ratio (HR) of 0.63 for dementia and an HR of 0.81 for ischemic stroke, indicating a statistically significant reduction in risk.

In addition to Dr. Lin, Sarah Marzi, PhD, from the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, highlighted the potential clinical implications of these findings. Marzi noted that if future trials confirm the neuroprotective properties of GLP-1 RAs, these medications could be utilized for disease prevention strategies in at-risk populations. Marzi, however, was not involved in the current research.

Despite the promising results, the study's authors acknowledged certain limitations. As an observational study, it could not fully account for unmeasured confounding factors, such as frailty and functional status, which might introduce bias. Moreover, the research database did not include biomarker data or neuroimaging assessments, which could have provided deeper insights into the mechanisms at play.

The study was funded by the Ministry of Science and Technology, Taiwan, and the Chang Gung Memorial Hospital, with no reported conflicts of interest among the investigators. The findings have the potential to reshape the therapeutic landscape for T2D and obesity management, suggesting an expanded role for GLP-1 RAs in mitigating the risks of serious neurological complications.

In conclusion, the association between GLP-1 RAs and reduced risks of dementia and ischemic stroke among adults with T2D and obesity underscores the need for ongoing research into their neuroprotective effects. As the medical community awaits further clinical trials, these findings may herald a new era in the prevention of neurodegenerative diseases linked to metabolic disorders.