Can SGLT2 Inhibitors Affect Dementia?
A target trial emulation using Veterans Affairs electronic health records examined neuropsychiatric outcomes associated with SGLT2 inhibitor use.
By
Kathryn Wighton
July 31, 2026
Clinical Scorecard: Can SGLT2 Inhibitors Affect Dementia?
At a Glance
Category Detail
Condition All-cause dementia Key Mechanisms SGLT2 inhibitors may lower the likelihood of incident dementia among older patients with psychiatric disorders. Target Population Patients aged 65 years or older with major depressive disorder, bipolar disorder, or schizophrenia spectrum disorder. Care Setting Retrospective cohort study using US Department of Veterans Affairs electronic health record data.
Key Highlights
SGLT2 inhibitor initiation associated with 39% lower odds of all-cause dementia. Sustained SGLT2 inhibitor use linked to 46% lower odds of dementia and psychiatric hospitalization. Absolute 5-year dementia risk: 1.6% for SGLT2 initiators vs. 2.9% for noninitiators. Study included 112,725 patients, predominantly male. Residual confounding may affect results. Guideline-Based Recommendations
Diagnosis
Use of ICD-9 codes for Alzheimer's disease and related dementias. Management
Consider SGLT2 inhibitors in older patients with psychiatric disorders. Monitoring & Follow-up
Monitor for psychiatric emergency department visits and hospitalizations. Risks
Potential residual confounding and misclassification of diagnoses. Patient & Prescribing Data
Older patients with psychiatric disorders and no prior dementia diagnosis.
SGLT2 inhibitors may serve as a transdiagnostic treatment option.
Clinical Best Practices
Conduct further investigations into SGLT2 inhibitors for high-risk psychiatric patients. Utilize dynamic eligibility criteria to reduce reverse causation. Related Resources & Content
