From a question
In adults with type 2 diabetes, are GLP-1 receptor agonists associated with a lower risk of dementia or cognitive decline compared with other glucose-lowering drugs?
DoneStarted Oct 28, 2026, 17:59 UTCFinished Oct 28, 2026, 18:02 UTCVersion 2
Stages
- Finding the known studies(done)
- Drafting(done)
- Checking MeSH(done)
- Counting in PubMed(done)
- Checking known studies(done)
- Comparing with the reference(done)
- Run Search(done)
- Saving(done)
Run log (20)
- Finding the known studies: No known studies were given
- Drafting: Drafting concepts and terms
- Checking MeSH: Checking every MeSH heading, Supplementary Concept and publication type against NLM
- Counting in PubMed: Running 13 lines on PubMed
- Line 2: 247,825 records
- Line 3: 297,627 records
- Line 4: 23,330 records
- Line 6: 42,071 records
- Line 7: 482,263 records
- Line 8: 1,068,413 records
- Line 10: 752 records
- Line 1: 204,451 records
- Line 11: 4,884,955 records
- Line 12: 725 records
- Line 13: 709 records
- Line 9: 1,156,402 records
- Line 5: 40,424 records
- Run Search: Fetching the first 20 records
- Saving: Saving the run
- Finished.
Final count (line 13)
709
Query as run (1,398 characters)
(((("Diabetes Mellitus, Type 2"[Mesh:NoExp]) OR ("type 2 diabetes"[tiab] OR "type II diabetes"[tiab] OR "diabetes mellitus type 2"[tiab] OR T2DM[tiab] OR T2D[tiab] OR "non-insulin-dependent diabetes"[tiab] OR NIDDM[tiab] OR "adult onset diabetes"[tiab])) AND (("Glucagon-Like Peptide-1 Receptor Agonists"[Mesh] OR "Glucagon-Like Peptide-1 Receptor"[Mesh] OR "Glucagon-Like Peptide 1"[Mesh] OR "Liraglutide"[Mesh] OR "Exenatide"[Mesh] OR "Semaglutide"[Mesh] OR "dulaglutide"[Supplementary Concept] OR "lixisenatide"[Supplementary Concept] OR "Tirzepatide"[Mesh]) OR ("glucagon-like peptide-1"[tiab] OR "GLP-1"[tiab] OR "GLP-1RA"[tiab] OR "GLP-1RAs"[tiab] OR GLP1RA[tiab] OR GLP1RAs[tiab] OR "incretin mimetic*"[tiab] OR "incretin-based"[tiab] OR liraglutide[tiab] OR semaglutide[tiab] OR dulaglutide[tiab] OR exenatide[tiab] OR lixisenatide[tiab] OR albiglutide[tiab] OR tirzepatide[tiab] OR efpeglenatide[tiab])) AND (("Dementia"[Mesh] OR "Cognitive Dysfunction"[Mesh] OR "Cognition Disorders"[Mesh] OR "Memory Disorders"[Mesh] OR "Cognition"[Mesh:NoExp]) OR (dement*[tiab] OR Alzheimer*[tiab] OR cognit*[tiab] OR "memory impairment"[tiab] OR "memory loss"[tiab] OR "memory decline"[tiab] OR neurodegenerat*[tiab]))) NOT ("Comment"[Publication Type] OR "Editorial"[Publication Type] OR "Letter"[Publication Type] OR "Case Reports"[Publication Type] OR "Preprint"[Publication Type])) AND english[la]Known studies
No known studies were given, so recall was not checked.
Only studies the model never saw are counted. Finding known studies does not prove the search is complete.
Reference strategy
No reference strategy was given.
Search lines
| No. | Search | Results |
|---|---|---|
| 1 | Type 2 diabetes "Diabetes Mellitus, Type 2"[Mesh:NoExp] (MeSH heading valid: D003924) | 204,262 |
| 2 | Type 2 diabetes "type 2 diabetes"[tiab] OR "type II diabetes"[tiab] OR "diabetes mellitus type 2"[tiab] OR T2DM[tiab] OR T2D[tiab] OR "non-insulin-dependent diabetes"[tiab] OR NIDDM[tiab] OR "adult onset diabetes"[tiab] | 247,825 |
| 3 | Type 2 diabetes · block 1 OR 2 | 297,442 |
| 4 | GLP-1 receptor agonists "Glucagon-Like Peptide-1 Receptor Agonists"[Mesh] (MeSH heading valid: D000097789) OR "Glucagon-Like Peptide-1 Receptor"[Mesh] (MeSH heading valid: D000067757) OR "Glucagon-Like Peptide 1"[Mesh] (MeSH heading valid: D052216) OR "Liraglutide"[Mesh] (MeSH heading valid: D000069450) OR "Exenatide"[Mesh] (MeSH heading valid: D000077270) OR "Semaglutide"[Mesh] (MeSH heading valid: D000099194) OR "dulaglutide"[Supplementary Concept] (Supplementary Concept valid: C555680) OR "lixisenatide"[Supplementary Concept] (Supplementary Concept valid: C479460) OR "Tirzepatide"[Mesh] (MeSH heading valid: D000098860) | 23,330 |
| 5 | GLP-1 receptor agonists "glucagon-like peptide-1"[tiab] OR "GLP-1"[tiab] OR "GLP-1RA"[tiab] OR "GLP-1RAs"[tiab] OR GLP1RA[tiab] OR GLP1RAs[tiab] OR "incretin mimetic*"[tiab] OR "incretin-based"[tiab] OR liraglutide[tiab] OR semaglutide[tiab] OR dulaglutide[tiab] OR exenatide[tiab] OR lixisenatide[tiab] OR albiglutide[tiab] OR tirzepatide[tiab] OR efpeglenatide[tiab] | 40,424 |
| 6 | GLP-1 receptor agonists · block 4 OR 5 | 42,071 |
| 7 | Dementia and cognitive decline "Dementia"[Mesh] (MeSH heading valid: D003704) OR "Cognitive Dysfunction"[Mesh] (MeSH heading valid: D060825) OR "Cognition Disorders"[Mesh] (MeSH heading valid: D003072) OR "Memory Disorders"[Mesh] (MeSH heading valid: D008569) OR "Cognition"[Mesh:NoExp] (MeSH heading valid: D003071) | 482,263 |
| 8 | Dementia and cognitive decline dement*[tiab] OR Alzheimer*[tiab] OR cognit*[tiab] OR "memory impairment"[tiab] OR "memory loss"[tiab] OR "memory decline"[tiab] OR neurodegenerat*[tiab] | 1,068,413 |
| 9 | Dementia and cognitive decline · block 7 OR 8 | 1,156,402 |
| 10 | combined 3 AND 6 AND 9 | 752 |
| 11 | excluded "Comment"[Publication Type] (publication type valid: D016420) OR "Editorial"[Publication Type] (publication type valid: D016421) OR "Letter"[Publication Type] (publication type valid: D016422) OR "Case Reports"[Publication Type] (publication type valid: D002363) OR "Preprint"[Publication Type] (publication type valid: D000076942) | 4,884,955 |
| 12 | exclusions removed 10 NOT 11 | 725 |
| 13Final | limits 12 AND english[la] | 709 |
Issues
- Error: "albiglutide" is not a Supplementary Concept. Kept as a disabled text term.
- Warning: Language limit (english): it can remove relevant studies; report and justify it.
- Warning: Publication types excluded with NOT (Comment, Editorial, Letter, Case Reports, Preprint): report and justify the exclusion.
First records
- Impact of GLP-1 Receptor Agonists on Cognitive Performance in Adults at Risk of Alzheimer's Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. (PubMed, opens in a new tab)
Abbatecola AM, Migliara G, D'Agostino F et al. · Nutrients · 2026 · PMID 42942883
- Neuropsychiatric Outcomes Associated With GLP-1 Receptor Agonist Use in Medicare Beneficiaries With Type 2 Diabetes: Variation by Treatment Pattern and Obesity Status. (PubMed, opens in a new tab)
Baik SH, Baye F, Xian H et al. · Diabetes, obesity & metabolism · 2026 · PMID 42928425
- Modern antidiabetic therapy in older adults with type 2 diabetes: evidence, best practice and a clinical pharmacist's framework. (PubMed, opens in a new tab)
Martinc B, Šabovič M, Janić M et al. · Expert review of clinical pharmacology · 2026 · PMID 42911774
- Diabetes-Associated Cognitive Dysfunction: Pathophysiology, Molecular Mechanisms, and Emerging Therapeutic Strategies. (PubMed, opens in a new tab)
Sarkar R, Kabra A, S Saeedan A et al. · ACS pharmacology & translational science · 2026 · PMID 42871641
- The effects of improved access to diabetes medications on risk of Alzheimer's disease and related dementias. (PubMed, opens in a new tab)
Barthold D, Zissimopoulos J, Basu A et al. · Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026 · PMID 42860380
- GLP-1 receptor agonists in perimenopause and early postmenopause: clinical role, cardiometabolic benefits and knowledge gaps. (PubMed, opens in a new tab)
Ozcivit Erkan IB, Senturk LM, Erel CT et al. · Climacteric : the journal of the International Menopause Society · 2026 · PMID 42847987
- GLP-1 Receptor Agonists Versus DPP-4 Inhibitors and Incident Dementia Risk in COVID-19 Survivors with Type 2 Diabetes: A Target Trial Emulation Study. (PubMed, opens in a new tab)
Hung KC, Yu TS, Liu PH et al. · Drug design, development and therapy · 2026 · PMID 42831108
- Mitohormesis linking metabolic dysfunction and neurodegeneration: implications for dementia and therapeutic strategies. (PubMed, opens in a new tab)
Otoda T, Nakajima H, Takayama T · Frontiers in molecular neuroscience · 2026 · PMID 42812893
- Genetic Insights Into Protective Effects of GLP-1 Receptor Agonists on Stroke and Alzheimer Disease Across Ancestries. (PubMed, opens in a new tab)
Caro-Châtelier I, Sargurupremraj M, Yang C et al. · Neurology. Genetics · 2026 · PMID 42812740
- Benefits of sodium-glucose cotransporter 2 inhibitors versus glucagon-like peptide-1 receptor agonists in older patients with type 2 diabetes. (PubMed, opens in a new tab)
Mortada I, Paul K, Rice J et al. · Diabetes & vascular disease research · 2026 · PMID 42808164
- Trajectory-Oriented Brain Vulnerability Framework for Cognitive Decline in Type 2 Diabetes. (PubMed, opens in a new tab)
Komel J, Klen J · International journal of molecular sciences · 2026 · PMID 42794768
- The Interplay of Metabolic Dysfunction, Neuroinflammation, and Mitochondrial Dysfunction in Balance Impairment: Insights from Type 2 Diabetes Mellitus and Alzheimer's Disease. (PubMed, opens in a new tab)
Fakorede S, Lateef OM, Udefa AL et al. · Molecular neurobiology · 2026 · PMID 42789205
- Evoke (+) trials of semaglutide for early alzheimer's disease: Innovations, lessons, and implications. (PubMed, opens in a new tab)
Cummings JL, Scheltens P · The journal of prevention of Alzheimer's disease · 2026 · PMID 42785112
- The Intertwined Threat: How Diabetes Impacts Neurological Disorders - A Review Article. (PubMed, opens in a new tab)
Rajput P, Jakhar M, Kashyap A et al. · Acta neurologica Taiwanica · 2026 · PMID 42784708
- Dementia progression with GLP-1 receptor agonists in people with mild cognitive impairment and type 2 diabetes: target-trial emulation study. (PubMed, opens in a new tab)
Schechter M, Sehtman-Shachar DR, Fishkin A et al. · Alzheimer's & dementia (New York, N. Y.) · 2026 · PMID 42769274
- Comparative Risk of Nonarteritic Anterior Ischemic Optic Neuropathy Among Glucagon-Like Peptide-1 Receptor Agonists: An Integrated Safety and Mechanistic Analysis. (PubMed, opens in a new tab)
Sun H, Xin X, Yan J et al. · Diabetes, obesity & metabolism · 2026 · PMID 42768849
- Glucagon-like peptide-1 receptor agonists and cognitive function: beyond the metabolic effects. (PubMed, opens in a new tab)
Polyzos SA, Doulberis M, Zervogiannis N et al. · Hormones (Athens, Greece) · 2026 · PMID 42736531
- Glycolytic Reprogramming in Parkinson's Disease: From Bioenergetic Crosstalk to Therapeutic Modulation. (PubMed, opens in a new tab)
Yi Y, Chen C, He Y et al. · Medicinal research reviews · 2026 · PMID 42695230
- The Crosstalk Between Diabetes and Alzheimer's Disease: A Molecular Perspective. (PubMed, opens in a new tab)
Catakli D, Ozen-Basoglu O, Tuncgovde EB et al. · Basic & clinical pharmacology & toxicology · 2026 · PMID 42693696
- Shared Metabolic-Proteinopathy Axis in Alzheimer's Disease and Parkinson's Disease: Evidence for a Convergent but Not Identical Disease Spectrum. (PubMed, opens in a new tab)
Yao SY, Du MQ, Lin LX et al. · Aging medicine (Milton (N.S.W)) · 2026 · PMID 42688951
Export
The strategy file has the numbered lines with counts, the search date and the AI-use statement. PMIDs and MEDLINE are fetched from PubMed when you download, so they reflect PubMed today.
Checking PubMed for the current list of PMIDs…
Objective and notes from the draft
To determine whether, in adults with type 2 diabetes, treatment with glucagon-like peptide-1 (GLP-1) receptor agonists is associated with a lower risk of incident dementia or cognitive decline than treatment with other glucose-lowering drugs.
- The comparator (other glucose-lowering drugs) is not searched as a separate concept, so that studies comparing with placebo, with any active drug, or reporting class comparisons only in the full text are not missed.
- Tirzepatide, a dual GIP/GLP-1 receptor agonist, is included because it is often grouped with the class; remove it if the review is limited to selective GLP-1 receptor agonists.
- Parkinson disease and other non-dementia neurodegenerative outcomes are not searched as headings; the neurodegenerat* text word may retrieve some of these studies, which can be screened out.
- The truncated term cognit* is deliberately broad within the outcome block; it is combined with the diabetes and GLP-1 blocks, which keeps the final result set manageable.
- The diabetes block is required; studies of GLP-1 receptor agonists in mixed populations that mention type 2 diabetes only in the full text could be missed, so consider screening the GLP-1 AND dementia combination without the diabetes block if the result set allows.
Edit the strategy
Type 2 diabetesPopulation
297,442 records · 9 of 9 terms on · 4 suggestions off
- MeSH valid: D003924AI
"Diabetes Mellitus, Type 2"[Mesh:NoExp]
Specific heading for the review population; its narrower headings are all forms of type 2 diabetes.
- TextAI
"type 2 diabetes"[tiab]
Most common author wording; also matches type 2 diabetes mellitus.
- TextAI
"type II diabetes"[tiab]
Roman-numeral spelling variant.
- TextAI
"diabetes mellitus type 2"[tiab]
Inverted word order used by some authors and registries.
- TextAI
T2DM[tiab]
Standard abbreviation, often used alone in abstracts.
- TextAI
T2D[tiab]
Shorter abbreviation used in epidemiological studies.
- TextAI
"non-insulin-dependent diabetes"[tiab]
Older entry-term synonym of the heading.
- TextAI
NIDDM[tiab]
Abbreviation of the older synonym.
- TextAI
"adult onset diabetes"[tiab]
Older entry-term synonym of the heading.
Suggested MeSH entry terms (4, off)
- TextEntry term
"Maturity-Onset Diabetes"[tiab]
Synonym of the MeSH heading "Diabetes Mellitus, Type 2" (D003924)
- TextEntry term
"Maturity-Onset Diabetes Mellitus"[tiab]
Synonym of the MeSH heading "Diabetes Mellitus, Type 2" (D003924)
- TextEntry term
"Noninsulin-Dependent Diabetes Mellitus"[tiab]
Synonym of the MeSH heading "Diabetes Mellitus, Type 2" (D003924)
- TextEntry term
"MODY Maturity-onset diabetes of the young"[tiab]
Synonym of the MeSH heading "Diabetes Mellitus, Type 2" (D003924)
GLP-1 receptor agonistsIntervention
42,071 records · 25 of 26 terms on · 20 suggestions off
- MeSH valid: D000097789AI
"Glucagon-Like Peptide-1 Receptor Agonists"[Mesh]
Pharmacological-action heading for the drug class under review.
- MeSH valid: D000067757AI
"Glucagon-Like Peptide-1 Receptor"[Mesh]
Receptor heading often assigned to studies of agonists indexed before the drug-class heading existed.
- MeSH valid: D052216AI
"Glucagon-Like Peptide 1"[Mesh]
Hormone heading used for GLP-1 analogues in older indexing.
- MeSH valid: D000069450AI
"Liraglutide"[Mesh]
Heading for a widely studied GLP-1 receptor agonist.
- MeSH valid: D000077270AI
"Exenatide"[Mesh]
Heading for the first marketed GLP-1 receptor agonist.
- MeSH valid: D000099194AI
"Semaglutide"[Mesh]
Supplementary Concept for semaglutide, a major agent in recent cohort studies and trials.
- SCR valid: C555680AI
"dulaglutide"[Supplementary Concept]
Supplementary Concept for dulaglutide, studied in the REWIND cognitive analyses.
- SCR valid: C479460AI
"lixisenatide"[Supplementary Concept]
Supplementary Concept for lixisenatide.
- TextAI
albiglutide[tiab]
proposed as a Supplementary Concept; no such record
- Error: "albiglutide" is not a Supplementary Concept. Kept as a disabled text term.
- MeSH valid: D000098860AI
"Tirzepatide"[Mesh]
Supplementary Concept for the dual GIP/GLP-1 receptor agonist, often grouped with the class.
- TextAI
"glucagon-like peptide-1"[tiab]
Full name of the hormone; covers receptor agonist and analogue phrasing.
- TextAI
"GLP-1"[tiab]
Standard abbreviation; also matches GLP1 and GLP-1 RA phrasings.
- TextAI
"GLP-1RA"[tiab]
Joined abbreviation not matched by the GLP-1 phrase.
- TextAI
"GLP-1RAs"[tiab]
Plural of the joined abbreviation, listed because the stem is too short to truncate.
- TextAI
GLP1RA[tiab]
Fully joined abbreviation variant.
- TextAI
GLP1RAs[tiab]
Plural of the fully joined abbreviation.
- TextAI
"incretin mimetic*"[tiab]
Older class name for GLP-1 receptor agonists.
- TextAI
"incretin-based"[tiab]
Term used for incretin-based therapies that include GLP-1 receptor agonists.
- TextAI
liraglutide[tiab]
Drug name for records not yet indexed.
- TextAI
semaglutide[tiab]
Drug name for records not yet indexed.
- TextAI
dulaglutide[tiab]
Drug name for records not yet indexed.
- TextAI
exenatide[tiab]
Drug name for records not yet indexed.
- TextAI
lixisenatide[tiab]
Drug name for records not yet indexed.
- TextAI
albiglutide[tiab]
Drug name for records not yet indexed.
- TextAI
tirzepatide[tiab]
Dual agonist name for records not yet indexed.
- TextAI
efpeglenatide[tiab]
Investigational long-acting GLP-1 receptor agonist studied in outcome trials.
Suggested MeSH entry terms (20, off)
- TextEntry term
"GLP1 Agonists"[tiab]
Synonym of the MeSH heading "Glucagon-Like Peptide-1 Receptor Agonists" (D000097789)
- TextEntry term
"GLP1R Agonists"[tiab]
Synonym of the MeSH heading "Glucagon-Like Peptide-1 Receptor Agonists" (D000097789)
- TextEntry term
"GLP-1R Agonists"[tiab]
Synonym of the MeSH heading "Glucagon-Like Peptide-1 Receptor Agonists" (D000097789)
- TextEntry term
"GLP1R Protein"[tiab]
Synonym of the MeSH heading "Glucagon-Like Peptide-1 Receptor" (D000067757)
- TextEntry term
"GLP1R Receptor"[tiab]
Synonym of the MeSH heading "Glucagon-Like Peptide-1 Receptor" (D000067757)
- TextEntry term
"GLP-1R Receptor"[tiab]
Synonym of the MeSH heading "Glucagon-Like Peptide-1 Receptor" (D000067757)
- TextEntry term
"NN-2211"[tiab]
Narrower concept "NN 2211" under the MeSH heading "Liraglutide" (D000069450)
- TextEntry term
Saxenda[tiab]
Narrower concept under the MeSH heading "Liraglutide" (D000069450)
- TextEntry term
Victoza[tiab]
Narrower concept under the MeSH heading "Liraglutide" (D000069450)
- TextEntry term
NN2211[tiab]
Narrower concept "NN 2211" under the MeSH heading "Liraglutide" (D000069450)
- TextEntry term
Byetta[tiab]
Narrower concept under the MeSH heading "Exenatide" (D000077270)
- TextEntry term
"AC 2993"[tiab]
Narrower concept under the MeSH heading "Exenatide" (D000077270)
- TextEntry term
Bydureon[tiab]
Narrower concept under the MeSH heading "Exenatide" (D000077270)
- TextEntry term
"ITCA 650"[tiab]
Narrower concept under the MeSH heading "Exenatide" (D000077270)
- TextEntry term
"AC 2993 LAR"[tiab]
Narrower concept under the MeSH heading "Exenatide" (D000077270)
- TextEntry term
Ozempic[tiab]
Narrower concept under the MeSH heading "Semaglutide" (D000099194)
- TextEntry term
Rybelsus[tiab]
Narrower concept under the MeSH heading "Semaglutide" (D000099194)
- TextEntry term
Mounjaro[tiab]
Narrower concept under the MeSH heading "Tirzepatide" (D000098860)
- TextEntry term
Zepbound[tiab]
Narrower concept under the MeSH heading "Tirzepatide" (D000098860)
- TextEntry term
LY3298176[tiab]
Narrower concept under the MeSH heading "Tirzepatide" (D000098860)
Dementia and cognitive declineOutcome
1,156,402 records · 12 of 12 terms on · 6 suggestions off
- MeSH valid: D003704AI
"Dementia"[Mesh]
Explodes to Alzheimer disease, vascular dementia and other dementias, all of which are review outcomes.
- MeSH valid: D060825AI
"Cognitive Dysfunction"[Mesh]
Heading for mild cognitive impairment and cognitive decline.
- MeSH valid: D003072AI
"Cognition Disorders"[Mesh]
Broader heading for cognitive impairment indexed without a more specific term.
- MeSH valid: D008569AI
"Memory Disorders"[Mesh]
Heading for memory impairment, a core feature of cognitive decline.
- MeSH valid: D003071AI
"Cognition"[Mesh:NoExp]
Captures studies measuring cognitive function as an outcome; not exploded to avoid unrelated narrower headings.
- TextAI
dement*[tiab]
Covers dementia, dementias and demented.
- TextAI
Alzheimer*[tiab]
Covers Alzheimer, Alzheimer's and Alzheimers disease.
- TextAI
cognit*[tiab]
Covers cognition, cognitive decline, cognitive impairment, cognitive function and neurocognitive outcomes in the abstract.
- TextAI
"memory impairment"[tiab]
Cognitive sense of memory, phrased to avoid immunological memory.
- TextAI
"memory loss"[tiab]
Lay and clinical wording for memory decline.
- TextAI
"memory decline"[tiab]
Wording used in longitudinal cognitive studies.
- TextAI
neurodegenerat*[tiab]
Captures studies framing dementia as neurodegenerative disease.
Suggested MeSH entry terms (6, off)
- TextEntry term
Amentia[tiab]
Synonym of the MeSH heading "Dementia" (D003704)
- TextEntry term
Overinclusion[tiab]
Narrower concept under the MeSH heading "Cognition Disorders" (D003072)
- TextEntry term
"Spatial Memory Disorder"[tiab]
Narrower concept "Memory Disorder, Spatial" under the MeSH heading "Memory Disorders" (D008569)
- TextEntry term
"Semantic Memory Disorder"[tiab]
Narrower concept "Memory Disorder, Semantic" under the MeSH heading "Memory Disorders" (D008569)
- TextEntry term
"Age-Related Memory Disorders"[tiab]
Narrower concept under the MeSH heading "Memory Disorders" (D008569)
- TextEntry term
"Memory Deficits"[tiab]
Narrower concept under the MeSH heading "Memory Disorders" (D008569)
Limits
Publication types to exclude
Each one is checked against MeSH publication types before it is added.
- Comment
- Editorial
- Letter
- Case Reports
- Preprint
No changes.