Can GLP-1 Agonists Fix What Ails You — and Ward Off Dementia Too?

Popular drugs approved for diabetes control and weight loss produce many other effects in the body as well. Drugs like semaglutide (Ozempic, Wegovy) have helped some people cut back on alcohol consumption. Others seem to get cardiovascular benefits in the form of fewer heart attacks and strokes. Now a study suggests that people taking such GLP-1 agonists may reduce their risk of developing Alzheimer disease or similar dementias (JAMA Neurology, April 7, 2025).

Ozempic vs. Dementia:

The authors of the latest study reviewed data from 33,858 Floridians over 50 with type 2 diabetes. Over 10,000 were taking GLP-1 agonists. Another group of 10,524 people with type 2 diabetes were taking a different category of glucose-lowering medicines called SGLT2 inhibitors known as gliflozins. You may recognize the names dapagliflozin (Farxiga) and empagliflozin (Jardiance).  The researchers analyzed health records from 2014 through 2023.

The results suggest that type 2 diabetes increases the risk for Alzheimer disease and related dementias. That’s because the relative risk reduction was impressive, calculated at 33 to 43 percent with both the GLP-1 agonists and the SGLT2 inhibitors.

The absolute risk reduction is, as usual, less dramatic: 2.26 fewer individuals on semaglutide developed dementia over 1,000 person-years. The rate for the gliflozins was about 3 fewer per 1,000 person-years. Rather than placebo, other diabetes drugs provided the comparison. The authors note that these findings might encourage doctors to consider one of these medications for people with type 2 diabetes concerned about dementia.

Are GLP-1 Agonists the Swiss Army Knife of Medicine?

We have been very cautious about endorsing GLP-1 agonists such as semaglutide (Ozempic, Rybelsus, Wegovy), liraglutide (Victoza and Saxenda) or tirzepatide (Mounjaro and Zepbound). This latter drug activates both a GLP-1 and a GIP-1 receptor. Forgive me for not delving into the pharmacology in this article. If you are interested in how these drugs work, here is a link that will provide you with much more information.

We try to be careful to give new “breakthrough” drugs adequate time to prove themselves. We also want to learn about adverse reactions that may not show up adequately in clinical trials. But enough time has passed that we now feel we can report on the pros and cons of such medications.

Scientists analyzed the health records of nearly two million veterans with diabetes (Nature Medicine, Jan. 20, 2025). Approximately 216,000 of them started on a drug like semaglutide. How well did the GLP-1 agonists perform?

The database in the analysis included an average of about 4 years of healthcare, offering the opportunity to see if some conditions were less common for people on these medications, called GLP-1 agonists. The investigators looked at 175 different health outcomes.

In addition to cardiometabolic disorders, the drugs were associated with a lower likelihood of clotting problems, dementia and other neurocognitive disorders, substance use and psychotic disorders, seizures, infectious illness and respiratory problems.

Remember, these investigators were comparing different kinds of diabetes treatments. When compared with “usual care,” the GLP-1 agonists outperformed other diabetes drugs in these key areas:

Other benefits of GLP-1 agonists:

Reduced Risk of:

• Alcohol use disorders
• Stimulant use disorders
• Suicidal ideation or self-harm
• Bulimia
• Schizophrenia and other psychotic disorders
• Seizures
• Neurocognitive disorders (dementia/Alzheimer disease)
• Clotting disorders (pulmonary embolism, DVT)
• Infections (bacterial pneumonia)

Before you get too excited about this information, the “reduced risk” is relatively modest. These are relative risk reductions. For example, the decreased risk of lung problems like pneumonia or bronchitis was about 13%. The relative risk reduction in suicidal ideation was about 10% and the dementia decrease was about 8%.

These numbers are very small in the global scheme of things. Such drugs are not cures for schizophrenia or lung problems. But losing weight probably reduces inflammation and insulin resistance. Those outcomes will be beneficial for the entire body. Another way to think about this is that obesity creates many negative health consequences. Reversing that situation can lead indirectly to a number of health benefits.

The Flip Side of the GLP-1 Agonists Coin:

Increased Risk of:

• Abdominal pain
• Nausea and diarrhea
• Vomiting
• GERD (gastrointestinal reflux disease)
• Gastroparesis (food does not move out of the stomach normally)
• Arthritis/arthralgia
• Pancreatitis
• Kidney concerns
• Low blood pressure or fainting

Summing up the Benefits and Risks of GLP-1 Agonists:

The authors conclude:

“In this study, we followed 1,955,135 individuals for a median of 3.68 (2.05−5.37) years—altogether corresponding to 7,239,854 person-years—to systematically map an atlas of the associations between GLP-1RA use and 175 health outcomes.

“Compared to the main control of usual care, GLP-1RA use was associated with a reduced risk of several substance use disorders, seizures, neurocognitive disorders (including Alzheimer’s disease and dementia), coagulation and clotting disorders, cardiorenal and metabolic disorders, infectious illnesses, several respiratory conditions (for example, COPD), hepatic failure and inflammatory bowel disease. There was an increased risk of several gastrointestinal disorders, hypotension [low blood pressure], syncope [fainting], arthritic disorders, nephrolithiasis [kidney stones], interstitial nephritis [kidney inflammation] and drug-induced pancreatitis.”

Putting the GLP-1 Agonists Into Perspective

Drugs like semaglutide can help many people lose weight. They also help control blood glucose. That seems unequivocal. That they may have some ancillary benefits also seems beneficial. But before you consider GLP-1 agonists a panacea, please realize that side effects like nausea and diarrhea can be overwhelming for some people. They have been categorized by visitors to this website as an “intestinal apocalypse.” Weighing the pros and cons is very much an individual matter with medical oversight. Here is an overview you may find helpful.

Here are just a few stories from visitors to this website:

Jan has had a positive experience with Wegovy:

“As someone who suffers from food addiction and PCOS, losing weight isn’t easy for me. My next step was gastric bypass because my weight was affecting my health and daily activities.

“Wegovy has changed my life. It has taken away my cravings and stress eating. I can now take my dogs on a walk. I am much more active as well as incredibly happy. I am going to the gym and have a personal trainer.”

Agatha was down and then up after Ozempic:

“I was on Ozempic for 6 weeks. I was constantly nauseated and vomiting. I lost 15 pounds. Could not tolerate the medication. After stopping it I gained 10 pounds back in 2 weeks.”

Harold got good results from Ozempic:

“I have been taking Ozempic for 16 months with no serious side effects. I have type 2 diabetes, and A1C of over 7 for several years. Nothing helped. After 1 month of Ozempic my A1C has been 5.6 or below. I have lost 45 lbs. I am not hungry. I take half dose of Miralax in AM. No bowel problems. Now if they find something to grow hair I will be happy.”

David could not tolerate Ozempic:

“I was taking Ozempic for type 2 diabetes. I got up to 0.5 mg and after several weeks began to have severe nausea and constipation. I lowered the dose back to 0.25, but eventually experienced the same symptoms. I had to stop taking Ozempic.

“I had developed severe nausea and anorexia and constipation, and they all resolved about a week or two after discontinuing Ozempic. Sure, I lost about 20 lbs (I started at about 220), but the gastric side effects were intolerable. I don’t know how anyone can take 0.5 mg unless I am particularly sensitive to the drug.”

Paula could not stomach Ozempic:

“Side effects should be counted. This drug (ozempic) caused nausea & vomiting for an entire week (couldn’t keep anything down), not to mention jaundice and abnormal liver blood work. That was after ONE dose! Having a liver ultra sound this week. Never taking any of these drugs again!”

Final Words:

Losing weight and controlling blood sugar are difficult. There are a lot of people who cannot manage either or both on their own. If medications like the GLP-1 agonists can help people overcome these challenges, we are grateful, especially if the side effects do not become a problem.

We have long suspected that Alzheimer disease and some  related dementias are related in some way to blood glucose dysregulation. If drugs like Ozempic, Jardiance and Farxiga can help people control blood sugar and reduce the risk of dementia, that is very good news. We will be reviewing long-term studies to get a better sense of the benefits and risks of these medications, especially when it comes to their impact on Alzheimer disease.

Feedback please! Have you tried one of the GLP-1 agonists? If so, please share your story in the comment section below.