A study of 1.71 million people shows that semaglutide reduces the risk of dementia by 46%
When it comes to semaglutide, the first reaction of most people is to become a popular "weight loss miracle drug" on social media - it has become a "hot commodity" in the fitness and beauty circles due to its significant weight loss effect.
But few people know that this drug, known for its "slimming" effect, may also have a "hidden skill" that can rewrite the health landscape: fighting dementia.
1、 Heavy data from 1.71 million patients: dementia risk drops by 46%. Recently, a US research team published a study in the Journal of Alzheimer's Disease that could overturn cognition.
They retrieved the long-term health data of 1.71 million type 2 diabetes patients from the U.S. Veterans Health Database and the Commercial Insurance Database.
Using the "target trial simulation" method (a research design that closely resembles real clinical decision-making as much as possible), the effects of semaglutide were compared with seven other commonly used hypoglycemic drugs (such as insulin, metformin, SGLT2 inhibitors, etc.), with a follow-up period of up to 3 years.
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The result shook the entire medical community.
Compared with insulin, patients who use semaglutide have a direct 46% reduction in dementia incidence (hazard ratio HR=0.54, 95% confidence interval 0.49-0.59)
——This means that for every 1000 patients, those who use semaglutide will have about 7 fewer cases of dementia compared to those who use insulin;
Even compared with metformin, the "cornerstone drug" for the treatment of diabetes, smeglutide can still reduce the risk of dementia by 33%;
More noteworthy is that even compared to Liraglutide, another commonly used hypoglycemic drug, which is also a GLP-1 receptor agonist, semaglutide still provides 20% more dementia protection.
The researchers emphasized that this is currently the largest association study between ADRD and hypoglycemic drugs, with a sample size of 1.71 million, providing strong real-world reference value for the data.
Meanwhile, subgroup analysis found that patients under the age of 65, female patients, and obese individuals had a more significant decrease in dementia risk after using semaglutide.
Researchers speculate that this is related to the "exacerbating" effect of obesity and vascular damage in the course of dementia - semaglutide can not only lose weight, but also improve metabolism and blood vessels, precisely targeting the risk pain points of these populations.
More importantly, these findings are not isolated evidence.
Animal experiments in Nature Aging in 2023 have confirmed that GLP-1 drugs can enhance the learning and memory abilities of mice;
A clinical observation conducted by the University of Copenhagen in Denmark in 2024 also found that individuals who use GLP-1 receptor agonists experience slower cognitive decline.
The combination of evidence from different levels makes the "brain protective" potential of semaglutide increasingly credible.
2、 So, why can we 'cross boundary brain protection'? Scientists have proposed four possible pathways of action based on existing research:
1. Anti inflammatory
Chronic inflammation is seen as a 'hidden accelerator' of dementia - as stated in the 2022 Cell journal, long-term inflammation accelerates early pathological changes in Alzheimer's disease.
GLP-1 drugs can simultaneously reduce inflammation levels in both the peripheral and central brain of the body, which is equivalent to "cooling" the "hot" brain and delaying pathological progression.
3. The improvement of vascular diabetes patients is often accompanied by vascular injury, and cerebrovascular problems (such as arteriosclerosis, micro infarction) are an important incentive for dementia.
Simeglutide not only stabilizes blood sugar, but also reduces the risk of arteriosclerosis, improves vascular elasticity, and reduces the occurrence of cerebrovascular events, indirectly reducing the probability of vascular dementia.
4. Directly affecting the hippocampus, which is the core area of memory formation in the brain, research has found that there are a large number of GLP-1 receptors present here.
The PET imaging study in Nature Medicine in 2021 further confirmed that GLP-1 drugs can improve glucose metabolism in the brain.
5. Weight loss and obesity are clear risk factors for dementia, and the weight loss effect of semaglutide has long been proven.
The 2021 NEJM study showed that patients using the drug can lose an average of 15% weight. This weight loss effect is equivalent to an 'indirect chain break', reducing the negative impact of obesity on the brain from the source.
These four mechanisms overlap with each other, making semaglutide a potential dementia prevention strategy with "one drug, multiple targets" - targeting both the pathology itself and improving risk factors.
