---
title: "GLP-1 receptor agonists and reduced dementia risk in patients with CKD and type 2 diabetes"
id: "pubmed-41697144"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-41697144"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/41697144/"
doi: "10.1093/ndt/gfag032"
published_at: "2026-08-27T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# GLP-1 receptor agonists and reduced dementia risk in patients with CKD and type 2 diabetes
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-41697144
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/41697144/)
- **DOI:** [10.1093/ndt/gfag032](https://doi.org/10.1093%2Fndt%2Fgfag032)
- **Published At:** 2026-08-27T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Patients with **chronic kidney disease (CKD)** and **type 2 diabetes mellitus (T2DM)** face elevated risk of dementia and Alzheimer disease owing to vascular dysfunction, insulin resistance and chronic inflammation. - The study assessed whether **GLP-1 receptor agonists (GLP-1RAs)** are associated with lower dementia risk compared with **DPP4 inhibitors (DPP4is)** in CKD stage 3 or later patients with T2DM. - This was a retrospective cohort analysis using the TriNetX global research network of electronic medical records from 67 US healthcare organizations, identifying patients newly prescribed GLP-1RAs or DPP4is from 2015–01–01 to 2020–12–31. - Key exclusions: prior GLP-1RA or DPP4i use, dementia diagnosis within 12 months before index date, or recent hospitalization. - Primary outcomes included incidence of overall **dementia**, **Alzheimer disease**, vascular dementia, frontotemporal dementia, Parkinson disease, extrapyramidal and movement disorders, and dementia with Lewy bodies over follow-up of 90 days to 5 years. - Survival analysis used Kaplan–Meier curves and Cox proportional hazards models to compare risks between GLP-1RA and DPP4i cohorts. - GLP-1RA use was associated with a significantly lower risk of overall dementia (HR 0.80, 95% CI 0.71–0.91, P = .001) relative to DPP4i use. - GLP-1RAs were also associated with reduced risk of **Alzheimer disease** (HR 0.76, 95% CI 0.59–0.98, P = .033). - No significant differences were detected between GLP-1RAs and DPP4is for vascular dementia, frontotemporal dementia, Parkinson disease, extrapyramidal and movement disorders, or dementia with Lewy bodies. - Authors conclude GLP-1RA therapy may provide **neuroprotective** benefits beyond glycemic control in CKD stage 3+ patients with T2DM, but they note further research is needed to confirm findings and inform treatment strategies for this high-risk population.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC. * 2 Department of Medicine, Fu-Jen Catholic University School of Medicine, Taipei, Taiwan, ROC. * PMID: **41697144** * DOI: [ 10.1093/ndt/gfag032 ](https://doi.org/10.1093/ndt/gfag032) Item in Clipboard # GLP-1 receptor agonists reduce dementia and Alzheimer disease risk in diabetic patients with CKD Wen-Teng Lee et al. Nephrol Dial Transplant. 2026. Show details Display options Display options Format Abstract PubMed PMID Nephrol Dial Transplant Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Nephrol+Dial+Transplant%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Nephrol+Dial+Transplant%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/41697144/) . 2026 Aug 27;41(9):1673-1685. doi: 10.1093/ndt/gfag032. ### Authors [Wen-Teng Lee](https://pubmed.ncbi.nlm.nih.gov/?term=Lee+WT&cauthor_id=41697144)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/41697144/#short-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC."), [Jing-Tong Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+JT&cauthor_id=41697144)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/41697144/#short-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC."), [Ming-Hsien Tsai](https://pubmed.ncbi.nlm.nih.gov/?term=Tsai+MH&cauthor_id=41697144)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/41697144/#short-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/41697144/#short-view-affiliation-2 "Department of Medicine, Fu-Jen Catholic University School of Medicine, Taipei, Taiwan, ROC."), [Yu-Wei Fang](https://pubmed.ncbi.nlm.nih.gov/?term=Fang+YW&cauthor_id=41697144)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/41697144/#short-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/41697144/#short-view-affiliation-2 "Department of Medicine, Fu-Jen Catholic University School of Medicine, Taipei, Taiwan, ROC.") ### Affiliations * 1 Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC. * 2 Department of Medicine, Fu-Jen Catholic University School of Medicine, Taipei, Taiwan, ROC. * PMID: **41697144** * DOI: [ 10.1093/ndt/gfag032 ](https://doi.org/10.1093/ndt/gfag032) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) are at increased risk of developing dementia and Alzheimer's disease due to vascular dysfunction, insulin resistance and chronic inflammation. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown neuroprotective properties; however, their impact on dementia risk in diabetic patients with CKD remains uncertain. This study evaluated the association between GLP-1RA use and dementia risk in patients with CKD stage 3 or later, compared with dipeptidyl peptidase-4 inhibitors (DPP4is). **Methods:** This retrospective cohort study analyzed data from the TriNetX global research network, comprising electronic medical records from 67 healthcare organizations in the US Collaborative Network. We identified patients with CKD stage 3 or later and T2DM who were newly prescribed GLP-1RAs or DPP4is between 1 January 2015 and 31 December 2020. Patients with prior GLP-1RAs or DPP4i use, a dementia diagnosis within 12 months before the index date or recent hospitalization were excluded. The primary outcome was the incidence of dementia, Alzheimer's disease, vascular dementia, frontotemporal dementia, Parkinson's disease, extrapyramidal and movement disorders, and dementia with Lewy bodies, assessed over a follow-up period ranging from 90 days to 5 years. Statistical analyses included Kaplan-Meier survival curves and Cox proportional hazards models. **Results:** GLP-1RA use was associated with a significantly lower risk of dementia [hazard ratio (HR) 0.80, 95% confidence interval (CI) 0.71-0.91, P = .001] and Alzheimer's disease (HR 0.76, 95% CI 0.59-0.98, P = .033) compared with DPP4i use. However, no significant differences were observed in vascular dementia, frontotemporal dementia, Parkinson's disease, extrapyramidal and movement disorders, or dementia with Lewy bodies. **Conclusions:** GLP-1RA therapy may reduce the risk of dementia and Alzheimer's disease in patients with CKD stage 3 or later, offering potential neuroprotective benefits beyond glycemic control. Research is needed to confirm these findings and optimize treatment strategies for this vulnerable population. **Keywords:** Alzheimer’s disease; GLP-1 receptor agonists; chronic kidney disease; dementia; type 2 diabetes. © The Author(s) 2026. Published by Oxford University Press on behalf of the ERA. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. 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