Sodium-glucose cotransporter 2 (SGLT2) inhibitors, a class of antidiabetic medications with mitochondrial and metabolic properties, may lower the risk of dementia in people who have mental illness, according to a
study in
JAMA Network Open.
Why It’s Relevant
Metabolic abnormalities, including insulin resistance and mitochondrial dysfunction, are increasingly recognized as core features of both psychiatric and neurodegenerative diseases. With a new analysis suggesting that dementia is projected to cost
more than $800 billion this year, identifying prevention strategies is critical—especially in populations that are at-risk for dementia, such as individuals with other psychiatric conditions.
By the Numbers
- Researchers analyzed data on 112,725 older patients (ages 65 and up) within the U.S. Department of Veterans Affairs health care system; all patients had a diagnosis of major depressive disorder, bipolar disorder, or schizophrenia spectrum disorder.
- Among all patients, 6.8% had received a prescription for an SGLT2 inhibitor for at least three months between January 1, 2006, and June 1, 2024.
- Individuals who used an SGLT2 inhibitor had 39% lower odds of any dementia and 20% lower odds of a psychiatric emergency department visit than those who did not. SGLT2 use was not associated with fewer psychiatric hospitalizations, however.
- SGLT2 inhibitor use was associated with lower odds of dementia in adults with or without diabetes and those with or without comorbid posttraumatic stress disorder.
The Other Side
Most of the patients (93%) were male, which limits generalizability. In addition, most of the patients (87%) had major depressive disorder, so more analysis is necessary for other psychiatric conditions. The researchers were also not able to factor in patients’ baseline cognitive status or their psychiatric symptom severity into the analysis.
Takeaway Message
“Our results support reconceptualizing neuropsychiatric disorders as partly metabolically mediated brain diseases and strengthening the case for SGLT2 inhibitors as candidate therapeutics,” the researchers wrote.
Related Information
Source
David T. Liebers, et al. Sodium-glucose cotransporter 2 inhibitors and dementia risk in patients with psychiatric disorders. JAMA Network Open. Published online June 30, 2026. doi:10.1001/jamanetworkopen.2026.19985
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