Does Ozempic (Semaglutide) Lower the Risk of Dementia?

By now, you’ve probably heard of semaglutide in one way or another. This medication — part of a class called glucagon-like peptide-1 (GLP-1) receptor agonists — has made many headlines. 

There are a few different brand names, and a few different reasons to take it: 

• Wegovy (injectable) is approved for weight loss in people over age 12 and to reduce the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease and BMI over 29.

• Ozempic (injectable) is approved for treating Type 2 diabetes in adults and reducing the risk of cardiovascular death, heart attack, and stroke in adults with known cardiovascular disease.

• Rybelsus (oral) is approved for treating Type 2 diabetes in adults.

As experts continue to study semaglutide, it’s becoming clear that it may have even more health benefits. For example, it might also treat some types of liver disease and help people quit smoking. Recent studies suggest it could play a role in preventing or delaying dementia, too. 

People with diabetes, obesity, heart disease, or a history of strokes are at a higher risk for developing dementia. So, any treatment that could change that risk would be welcome news.

How might semaglutide (and similar medications) affect dementia risk? Here’s what the research has shown so far.

Can semaglutide prevent both Alzheimer’s dementia and other types of dementia?

To understand the research, it helps to understand dementia a little better. Dementia is a brain condition that affects someone’s ability to problem solve, remember things, communicate with others, and care for themselves. 

People with diabetes are at higher risk for two common types:

• Alzheimer’s dementia might be the most familiar and common type. It occurs when certain proteins, called amyloid plaques, build up in the brain. This buildup disrupts communication between nerve cells, eventually causing them to die.

• Vascular dementia can happen with atherosclerotic cardiovascular disease (ASCVD). This is when organs — like the brain — don’t get enough blood due to vascular disease. It’s a common complication of diabetes. Vascular dementia is also common after a stroke or ministrokes.

EXPERT PICKS: WHAT TO READ NEXT

• Semaglutide side effects: Semaglutide is effective for diabetes treatment and weight loss. But some of its side effects may be too difficult for some people to tolerate. 

• Is copycat semaglutide safe? If you can’t access or afford Ozempic or Wegovy, compounded semaglutide may seem like a tempting alternative. But is it worth the risk? Here’s what you need to know.

• Should you take semaglutide by mouth or injection? One option requires daily dosing, while the other is weekly. Understand the other differences between Rybelsus and Ozempic.

Recent research suggests that in both types of dementia, certain brain cells that usually help clean up waste die. Without this “clean-up crew,” problems build up in the brain and cause more damage.

Can semaglutide prevent dementia? What the research shows

It’s still too early to say for sure, but a recent flurry of research suggests it might:

• In one study, researchers looked at past data from U.S. electronic health records for more than 1 million people with Type 2 diabetes. They found that those taking semaglutide had a lower risk of being diagnosed with Alzheimer’s disease compared to people taking other diabetes medications. 

• In a similar systematic review of studies from Denmark, researchers included all GLP-1 agonists. They discovered a lower rate of dementia (any type) in people taking these medications for Type 2 diabetes. They didn’t find the same association with other types of diabetes medications.

• Another look at U.S. health records found similar results. People with Type 2 diabetes taking semaglutide had a lower risk of dementia compared to those taking sitagliptin, empagliflozin, and glipizide.

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While these results are promising, there are a few important caveats:

• These are retrospective studies (looking back at existing data), which aren’t the best quality studies. 

• They only found a link, not a cause-and-effect relationship. 

• These studies only included people with diabetes. So, these results shouldn’t be broadly applied at this time.

Could semaglutide treat early dementia?

Again, it’s too early to tell. But preliminary clinical trial data suggest liraglutide (also a GLP-1 agonist) might slow cognitive decline in people with Alzheimer’s. People who took the medication for 1 year also had less brain shrinkage (common in Alzheimer’s) compared to those who took placebo medication. But these study results haven’t been published or peer-reviewed yet. 

Two randomized, controlled trials with semaglutide are currently underway. Researchers want to learn if this treatment can slow the progression of dementia in people with early Alzheimer’s disease. These studies involve thousands of people across 38 different countries and should provide more insight into how semaglutide affects the brain (see below). 

How does semaglutide affect dementia risk?

Researchers aren’t sure exactly how this might happen, but they have some ideas: 

• Reducing dementia risk factors: One theory is that semaglutide has an indirect effect on the brain by addressing risk factors for dementia. For example, risk factors for dementia include Type 2 diabetes and having a BMI over 30. And semaglutide addresses both of these. But it’s worth mentioning that the U.S. study (mentioned above) found a decrease in dementia risk with semaglutide even in people without a BMI over 30. And studies haven’t found similar associations with other types of diabetes medications.

• Neuroprotection: Medications like semaglutide act on GLP-1 receptors to trigger insulin release. But GLP-1 is also a neurotransmitter, and these receptors are present in animal and human brains. In animal studies, GLP-1 receptor agonists like semaglutide seem to have a protective effect on the brain. Research suggests they reduce inflammation in the nervous system.

How to lower your risk of dementia

If you have diabetes or excess body weight, you might wonder how you can prevent dementia. It helps to know the risk factors so that you can address the ones you can change. 

Some risk factors you can’t change, including:

• Age

• Genetics 

Other risk factors sometimes can’t be avoided, like:

• Brain injury

• Depression

• Lower education level

• Air pollution

But research suggests healthy lifestyle choices can lower your risk of dementia, regardless of your genetic risk. That’s because other risk factors include:

• Hypertension (high blood pressure)

• Excessive alcohol use

• Smoking 

• Not enough physical activity

• Not enough social interactions

If you’re concerned about your risk for dementia, speak with a healthcare professional. They can help you better understand your risk and help you make changes to decrease it. 

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Written by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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