Ozempic May Lower Dementia Risk in People With Type 2 Diabetes, Study Finds

• Semaglutide, the main active ingredient in Ozempic, is linked to a lower risk of cognitive decline in a new study.
• The study only focused on patients with type 2 diabetes.
• Doctors say there may be something to this.

The last year has seen an explosion of research about the perks of taking Ozempic, a type 2 diabetes medication that some use off-label for weight loss. The injectable drug, which contains semaglutide, has been linked to everything from a lowered risk of kidney disease to helping break addictions. Now, there’s a new perk to consider: It may help lower your risk of cognitive decline and potentially dementia.

That’s the major takeaway from a new study published in the journal Lancet eClinical Medicine. For the study, researchers analyzed data from more than 100,000 patients in the U.S. with type 2 diabetes, including 20,000 who took semaglutide.

The researchers determined that semaglutide wasn’t linked to a higher risk of developing certain neurological or psychiatric conditions like anxiety or depression. They also found that people who took the medication had lower rates of cognitive decline than their counterparts who took other type 2 diabetes medications.

Meet the Experts: David Merrill, M.D., Ph.D., geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, CA; Kunal Shah, M.D., an assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center; Riccardo De Giorgi, M.D., researcher, psychiatrist and clinical lecturer at the University of Oxford; Paul Newhouse, M.D., director of the Vanderbilt Center for Cognitive Medicine

While the researchers stopped short of saying that Ozempic actually lowers your risk of developing cognitive decline, they note in the study that the findings should “stimulate validation in clinical trials.”

OK, but what’s behind this link? Doctors explain.

How does semaglutide work?

Semaglutide is an injectable medication that’s taken once a week. It’s approved by the Food and Drug Administration (FDA) under the name Ozempic to help with blood sugar management in patients with type 2 diabetes. But semaglutide is also FDA-approved for weight management in people with overweight or obesity under the name Wegovy.

Ozempic works by mimicking a protein in your body called glucagon-like peptide 1 (GLP-1), explains Kunal Shah, M.D., an assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center. When you take Ozempic, it activates GLP-1 receptors in your body, causing an increase in the production of insulin. Insulin, in case you’re not familiar with it, is a hormone that helps escort glucose (a.k.a. blood sugar) into your body’s cells, where it’s used for energy.

At the same time, Ozempic also works on your brain and gut. “It slows down the transit of food from the stomach to the gut,” Dr. Shah says. “It also modulates your feelings of hunger.” As a result, Ozempic makes you feel like eating less than when not taking the medication.

Why might semaglutide lower the risk of cognitive decline?

There are a few caveats to point out. It’s important to note that this particular study only looked at patients who had type 2 diabetes and took semaglutide (or other medications). Meaning, it’s not clear how taking semaglutide might impact the risk of cognitive decline in people without type 2 diabetes.

Also, this study didn’t prove that semaglutide actually lowered the risk of developing cognitive decline—it merely found a link between people who took the medication and those who were less likely to develop cognitive issues that could include dementia. “Because this study was observational in nature, we could only assess ‘associations’ rather than ‘causation,’” says Riccardo De Giorgi, M.D., who is the lead study author of the latest study, along with a psychiatrist and clinical lecturer at the University of Oxford.

That said, there may be something to this, according to David Merrill, M.D., Ph.D., geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, CA. Ozempic is in a class of drugs known as GLP-1 receptor agonists and “this class works through multiple mechanisms, in the pancreas, gut, and the brain,” Dr. Merrill says.

The impact on the brain, in particular, may be “neuroprotective”—meaning it protects nerve cells against damage and degeneration, Dr. De Giorgi says.

“There may be anti-inflammatory effects that lead to better outcomes with cognition and aging,” Dr. Merrill says. It’s also possible that Ozempic can improve the use of glucose in the brain, says Paul Newhouse, M.D., director of the Vanderbilt Center for Cognitive Medicine. “The exact mechanism of this potential benefit probably involves more than one single mechanism,” he adds.

But Dr. Merrill stresses that there’s a lot we don’t know at this point. “More research is needed,” he says.

Does semaglutide affect memory?

As of now, this hasn’t been well studied. “In general, it seems like semaglutide can improve overall health,” Dr. Merrill says. “Therefore, that may lead to improved memory performance.”

If someone regularly struggles with food noise, i.e. constantly thinking about food and hunger, taking a medication like Ozempic may help to clear that out and allow someone to focus better, he says.

But “in patients who do not have any memory problems, it is likely that there will be no direct effect on memory,” Dr. Newhouse says.

Can Ozempic cause confusion?

Confusion isn’t a common side effect of semaglutide. The drug’s website lists the following as Ozempic side effects:

• Nausea
• Diarrhea
• Stomach pain
• Vomiting
• Constipation

However, the FDA’s drug label for Ozempic notes that people on Ozempic can develop hypoglycemia (i.e. low blood sugar) and confusion is a symptom of low blood sugar.

That’s not necessarily specific to Ozempic, though. “Any medication that lowers blood sugar could cause hypoglycemia and confusion,” Dr. Merrill says.

Ozempic can also cause gastrointestinal symptoms like diarrhea and vomiting that could lead to dehydration and confusion, he says. “These would be indirect effects, though,” Dr. Merrill says.

Overall, experts say there’s a lot we still are learning about Ozempic. “The research is being played out in real-time and in large populations of people who are using the drug for a range of conditions, including off-label uses,” Dr. Merrill says. “It would be ideal to have more controlled clinical trials. Right now, the usage of the drug is a bit broad.”