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More evidence suggests that semaglutide drugs could help lower the risk of Alzheimer’s disease. Image credit: Scharvik/Getty Images.
  • Past research shows that people with type 2 diabetes have an increased risk for developing Alzheimer’s disease.
  • There is currently no cure for Alzheimer’s disease.
  • Researchers from Case Western Reserve University have now found that anti-diabetes medication semaglutide, sold under brand names like Ozempic, may help lower Alzheimer’s disease risk in people with type 2 diabetes, when compared to seven other drugs used to treat diabetes.

Past research shows that people with type 2 diabetes have a higher risk for developing Alzheimer’s disease — a type of dementia impacting a person’s memory and behavior that currently has no cure.

Researchers believe this is because some of the underlying issues related to type 2 diabetes — such as obesity, heart disease, and high blood pressure — can predispose a person to Alzheimer’s disease.

Additionally, diabetes can potentially damage blood vessels in the brain, which can further raise a person’s dementia risk.

Now, researchers from Case Western Reserve University in Cleveland, OH, have found that semaglutide — the active ingredient in diabetes medications Ozempic, Rybelsus, and Wegovy, the latter of which is also prescribed for weight loss — may help lower Alzheimer’s disease risk in people with type 2 diabetes, when compared to seven other drugs used to treat diabetes.

The study was recently published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

For this study, researchers analyzed medical history data over a three-year span from about 1 million people with type 2 diabetes in the United States, who had no prior Alzheimer’s disease diagnosis.

Scientists analyzed the data to compare Alzheimer’s disease occurrences between semaglutide and seven other medications used to treat diabetes:

  1. insulins
  2. metformin
  3. dipeptidyl-peptidase-4 inhibitors (DPP-4i)
  4. sodium-glucose cotransporter-2 inhibitors (SGLT2i)
  5. sulfonylureas (SUs)
  6. thiazolidinediones (TZDs)
  7. and other glucagon-like peptide receptor agonists (GLP-1RA).

“Semaglutide is a new generation of GLP-1RA for treating type 2 diabetes mellitus and obesity,” Rong Xu, PhD, professor of biomedical informatics and director of the Center for AI in Drug Discovery in the School of Medicine at Case Western Reserve University and lead author of this study explained to Medical News Today.

“Preclinical evidence suggests that semaglutide protects against neurodegeneration and neuroinflammation. In addition semaglutide treats obesity, type 2 diabetes, cardiovascular diseases, smoking, and alcohol drinking, all of which are risk factors for Alzheimer’s disease,” she told us.

“Therefore, we hypothesized that semaglutide could reduce the risk of Alzheimer’s disease by targeting — directly or indirectly — these modifiable risk factors, neurodegeneration and neuroinflammation,” Xu added.

Upon analysis, Xu and her team found that study participants prescribed semaglutide were correlated with 40% to 70% reduced risks of a first-time Alzheimer’s disease diagnosis, when compared to the other seven anti-diabetes medications.

The researchers reported that these reductions were similar across obesity status, age groups, and genders.

“Compared with each of seven other anti-diabetic medications including metformin and the first generation of GLP-1RA, semaglutide was associated with reduced risk of Alzheimer’s disease,” Xu said.

“These comparisons increased the robustness of our findings, especially since previous studies have shown that metformin and other GLP-1RAs are beneficial for Alzheimer’s disease,” she further notes

“Our study provides promising real-world evidence suggesting that semaglutide is beneficial in preventing or slowing the development of Alzheimer’s disease,” added Xu.

“I believe that semaglutide represents an exciting opportunity for preventing, delaying and treating Alzheimer’s disease. However, clinical trials are necessary to confirm the effects,” the researcher cautioned.

MNT also spoke with Verna Porter, MD, a board certified neurologist and director of the Dementia, Alzheimer’s Disease and Neurocognitive Disorders at Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CA, about this study, who said her first reaction is one of cautious optimism.

“The significant reduction in Alzheimer’s disease incidence associated with semaglutide is promising, particularly in a high-risk population like those patients with type 2 diabetes mellitus,” Porter noted. “It adds to the growing body of evidence suggesting that GLP-1 receptor agonists may have neuroprotective properties, which could benefit patients beyond glucose control.”

“However, as a clinician, I’m also aware of the need for further research, including longer-term studies and randomized controlled trials, to better understand the mechanisms and validate these findings before making changes to my treatment approach,” she added.

Porter said it is crucial for researchers to explore new ways of reducing Alzheimer’s disease risk, especially in people with type 2 diabetes, because these individuals already face an elevated risk of cognitive decline and dementia.

“The overlap between type 2 diabetes mellitus and Alzheimer’s disease stems from shared risk factors such as insulin resistance, inflammation, and increased risk for vascular damage. As Alzheimer’s disease is a progressive neurodegenerative disease with no cure, finding effective preventative strategies could notably improve the quality of life for patients with diabetes, reducing the burden of both diseases on patients, families, and healthcare systems.”

– Verna Porter, MD

Xu said their next research steps will include investigating if the same is true for neurodegenerative and neurological diseases, as well as examining tirzepatide — the active ingredient in Mounjaro and Zepbound — which she said is a more potent GLP-1RA.

“We will examine if semaglutide and tirzepatide have therapeutic effects in improving outcomes in patients with Alzheimer’s disease,” Xu added.

Porter said she would like to see longer-term, randomized controlled trials that specifically investigate semaglutide’s role in preventing or delaying Alzheimer’s disease onset in diverse populations.

“Further research should also explore the underlying mechanisms, such as its potential effects on neuroinflammation, mitochondrial function, and amyloid beta/tau pathology,” she continued.

“Additionally, it would be valuable to assess semaglutide’s impact on individuals without type 2 diabetes mellitus but at high risk for Alzheimer’s disease. Finally, studying other GLP-1 receptor agonists and combination therapies to see if similar neuroprotective benefits emerge would provide more comprehensive insights into this treatment approach,” said Xu.