Diabetes Medications Like Ozempic and Jardiance May Reduce Alzheimer’s Risk

Alzheimer’s & Ozempic

An increasing amount of evidence now indicates that some widely used type 2 diabetes medications may not only control blood sugar but also lower the risk of developing dementia, including Alzheimer’s disease. New research in JAMA Neurology suggests that drugs from the glucagon-like peptide-1 receptor agonist (GLP-1RA) and sodium-glucose cotransporter-2 inhibitor (SGLT2i) classes both significantly reduce the risk of dementia.

Study Overview: Key Findings

Researchers looked at data on more than 92,000 people aged 50 and older who had type 2 diabetes from states including Florida, Georgia and Alabama. During the study period, participants were tracked for the development of different types of dementia, including Alzheimer’s, vascular dementia, frontotemporal dementia and Lewy body dementia.

The study compared:

GLP-1RAs (e.g., Ozempic, Wegovy) versus alternative second-line glycemic-lowering agents.

SGLT2is (e.g., Jardiance) vs other drugs of similar make.

Head-to-head comparisons of both classes (GLP-1RAs vs. SGLT2is).

The results revealed:

The use of GLP-1RAs was associated with a 33% reduced risk of dementia.

SGLT2is were linked with a 43% reduced risk of dementia.

For other diabetes agents, no clear association with reduced risk was observed, indicating a class-specific benefit of these agents.

How Might These Drugs Be Protective of the Brain?

The precise mechanisms are still being studied, but there are several theories as to how these medications might lower dementia risk:

Neuroinflammation Reduction:

GLP-1RAs may also blunt inflammatory processes in the brain that likely play a role in neuronal injury.

Improved Insulin Signaling:

Optimizing blood glucose and improving insulin signalling across the brain is likely to optimize cellular health and function.

Improved Cerebral Perfusion and Reduced Oxidative Stress:

SGLT2 inhibitors seem to enhance blood flow to the brain and reduce oxidative stress levels, both of which are important determinants of cognitive function.

Promotion of Neurogenesis:

Some data suggests that they [GLP-1RAs] may help to stimulate growth of new nerve cells, such that cognition may be spared.

Decrease of Major Alzheimer’s Indicators:

Both classes of drugs have a demonstrated ability to lower levels of amyloid-beta and tau proteins — biomarkers that are generally elevated in Alzheimer’s disease.

“It is still the case that the brain and body do not age separately,” says Dr. William Kapp, a widely quoted longevity expert. Insulin resistance — a metabolic disorder — along with inflammation, now directly affects brain health.’ Professor David Strain at the University of Exeter takes the view that increased exercise is about a lot more than blipping up blood sugars, with vascular risk and inflammatory markers also contributing to the changes observed.

The Connection Between Diabetes and Dementia

Chronic inflammation and disrupted insulin signaling are just a few physiological shared characteristics between type 2 diabetes and dementia. Diabetes itself is already a risk factor for cognitive decline, and with these overlapping mechanisms, researchers theorized that therapies that improve metabolic control might also improve brain health.

For people with type 2 diabetes, the combined advantages of using GLP-1RAs and SGLT2is may lead to enhanced glycemic control, as well as a decreased potential for dementia in later life. However, these are early findings, and more prolonged studies are necessary to confirm the protective effects — and if those benefits apply to people without diabetes as well.

Constraints and Future Studies

Despite these encouraging results, several caveats exist:

Duration of Follow-Up:

The average follow-up time across the studies was less than five years. As dementia is a progressive condition that develops over many years, longer follow-up is needed to determine the complete impact.

Conflicting Data:

A parallel meta-analysis using a larger database confirmed the reduced risk associated with GLP-1RAs but failed to demonstrate a statistically significant effect of SGLT2is, emphasizing the need for further studies.

Generalizability:

Whether these drugs might protect others is unknown and they should be used with caution and only off label by the non-diabetics.

Expert Perspectives

The experts in the field are cautiously optimistic. This reduction in dementia risk is clinically observed and reinforces the importance of how metabolic health reflects brain health. As this research progresses, you can expect healthcare providers to have more weapons in their arsenal to fight both diabetes and neurodegenerative diseases with the same medications.

Conclusion

The results bolster the nascent perception that such medications — Ozempic, a GLP-1RA, and Jardiance, an SGLT2i — could offer major brain health benefits, cutting the risk that type 2 diabetes sufferers will develop dementia. It will take larger and longer-term studies to better understand this relationship, but such findings offer a tantalizing prospect for possible early intervention, which could change how we think about preventing Alzheimer’s disease and related dementias.

But for people with type 2 diabetes, sharing these results with a healthcare professional may be helpful in shaping treatment approaches that target metabolic and cognitive health, which can translate into an improved quality of life during aging.