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A large retrospective cohort study revealed that T2DM patients treated with GLP-1RAs exhibited a significantly reduced risk of developing dementia compared with those receiving other glucose-lowering therapies.126 In a clinical trial involving cognitively intact individuals aged 45–70 years at risk for AD, liraglutide administration for 12 weeks enhanced intrinsic connectivity within the default mode network as measured by resting-state functional magnetic resonance imaging, although no significant cognitive improvements were observed during the study period.127 In patients with mild cognitive impairment and AD, an 18-month course of exenatide was well tolerated but did not yield significant changes in clinical or cognitive outcomes or in most neuroimaging or biomarker assessments, except for a reduction in plasma neuronal extracellular vesicle Aβ42 levels, potentially reflecting systemic neuronal status
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