Risk of Dementia after initiation of GLP-1 RA versus long-acting insulin in patients with type 2 Diabetes mellitus.

Chien-Hung Lin, Peir-Haur Hung, Mu-Chi Chung, Laing-You Wu, Chi-Jung Chung

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Article in The journal of prevention of Alzheimer's disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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Opportunities to treat specific populations with repurposed drugs.The journal of prevention of Alzheimer's disease · 2026
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5 authors.

Chien-Hung LinDivision of Pediatric Immunology and Nephrology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; College of Science and Engineering, Fu Jen Catholic University, New Taipei, Taiwan.

Peir-Haur HungDepartment of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan.

Mu-Chi ChungDivision of Nephrology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Division of Clinical Toxicology, Department of Medical Toxicology, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung City, 402, Taïwan.

Laing-You WuDepartment of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.

Chi-Jung ChungDepartment of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. Electronic address: cjchung@mail.cmu.edu.tw.

Funding

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6 · The paper itself

Abstract

backgroundRecent studies suggest a decreased risk of dementia in patients treated with glucagon-like peptide-1 receptor agonist (GLP-1 RA). In this study, we compare the risk of dementia associated with GLP-1 RA versus long-acting insulin in adults aged over 50 years with type 2 diabetes (T2DM) using real-world administrative data from a large Taiwan cohort

designA population-based retrospective cohort study

settingWe analyzed 10,783 propensity score-matched pairs of adults with T2DM who initiated either GLP-1 RA or long-acting insulin from Taiwan's National Health Insurance Research Database (2011-2021). MEASUREMENTS: Primary outcome was new-onset dementia; secondary outcomes included dementia requiring treatment and specific dementia subtypes (Alzheimer's disease, vascular dementia, and unspecified dementia). Hazard ratios (HRs) were estimated using Cox models.

resultsAnalysis of matched pairs identified 375 cases of newly diagnosed dementia. The incidence rate was 4.86 per 1,000 person-years in GLP-1 RA users versus 7.56 in insulin users. GLP-1 RA use was associated with significantly lower risk of overall dementia (HR 0.64, 95% CI 0.46-0.89, P=0.0072) and unspecified dementia (HR 0.41, 95% CI 0.24-0.68, P=0.0006), but not for Alzheimer's disease (HR 1.48, 95% CI 0.61-3.63, P=0.3867) or vascular dementia (HR 1.66, 95% CI 0.21-13.03, P=0.6324). Among GLP-1 RAs, both liraglutide (HR 0.40, 95% CI 0.20-0.80, P=0.0091) and dulaglutide (HR 0.42, 95% CI 0.19-0.92, P=0.0311) showed significant protective effects against unspecified dementia.

conclusionsGLP-1 RA use was associated with lower dementia risk versus long-acting insulin in T2DM patients, especially with liraglutide and dulaglutide. As observational, causality requires confirmation from randomized controlled trials.

Indexed as

Basal insulinDementiaDiabetes mellitusGlucagon-like peptide-1 receptor agonistPropensity score–matchingRetrospective cohort study

Identifiers

PMID42570467

DOI10.1016/j.tjpad.2026.100645

PMCPMC13476480

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