{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:36:38Z","timestamp":1792024598897,"version":"4.4.0"},"reference-count":44,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>To address gaps in current research, this study aims to compare the impact of exposure to glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RA) versus sodium\u2010glucose cotransporter 2 inhibitors (SGLT2i), dipeptidyl peptidase 4 inhibitors (DPP4i), and sulfonylureas (SU) on reducing the risk of dementia, using a rigorous targeted learning causal inference approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Using clinical and claims data from four diverse US health\u2010care systems, we emulated three two\u2010arm trials contrasting sustained treatment with GLP\u20101RA versus SGLT2i, DPP4i, and SU on dementia diagnosis. We included diabetes patients aged \u2265 60 years who initiated medication between 2014 and 2022. We estimated cumulative risk differences at 2.5 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In Cohort 1, there was no evidence of differential dementia risk between sustained exposure to GLP1\u2010RA versus SGLT2i (adjusted risk difference [aRD] \u22120.001, 95% confidence interval [CI] \u22120.004, 0.001). In Cohorts 2 and 3, GLP\u20101RA was associated with reduced risk of dementia diagnosis compared to DPP4i and SU, respectively (aRD \u22120.013, 95% CI \u22120.017, \u22120.009; aRD \u22120.016, 95% CI \u22120.018, \u22120.015).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Rigorous causal inference analysis suggests that sustained exposure to GLP\u20101RA may modestly reduce risk of dementia, compared to DPP4i or SU exposure\u2014but not compared to SGLT2i.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>We researched the comparative effects of diabetes medications on dementia.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>We studied a large, diverse observational cohort of patients with diabetes in the United States.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RAs) may modestly reduce risk of dementia compared to dipeptidyl peptidase 4 inhibitor or sulfonylurea exposure.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>GLP\u20101RAs do not show evidence of dementia risk reduction compared to sodium\u2010glucose cotransporter 2 inhibitors.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Physicians may consider this when making prescription decisions with patients.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70621","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T12:02:58Z","timestamp":1757937778000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["GLP\u20101RA comparative effectiveness against dementia onset relative to other antidiabetic medications in a large, multi\u2010site cohort of patients with type 2 diabetes"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8407-2364","authenticated-orcid":false,"given":"Nerissa","family":"Nance","sequence":"first","affiliation":[{"name":"Kaiser Permanente Northern California Division of Research  Pleasanton California USA"},{"name":"University of California Berkeley School of Public Health  Berkeley California USA"},{"name":"Novo Nordisk A\/S  Bagsvaerd Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Gilsanz","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California Division of Research  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Karter","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California Division of Research  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Finertie","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California Division of Research  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Schmittdiel","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California Division of Research  Pleasanton California USA"},{"name":"Department of Health Systems Science Kaiser Permanente Bernard J. 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