Heart failure & cardiomyopathiesCohort study
Association of SGLT2 inhibitors and new-onset dementia in non-diabetic patients with heart failure
- Retrospective cohort study
- propensity-score matched
Authors' conclusion
In this large, real-world patient with HF without diabetes, SGLT2i therapy was associated with a significantly lower risk of new-onset dementia and all-cause mortality.
Study context
- Population
- Adults with heart failure (HF) and no prior dementia or diabetes, TriNetX Research Network (2016–2025)39,979 matched pairs analysed
- Participants
- 46,049 vs 205,010
- Exposure
- SGLT2i vs no SGLT2i
- SGLT2in = 46,049
- Non-usersn = 205,010reference
- Outcome
- New-onset dementia
- Follow-up
- Median 1.2 years
Main finding
As reported in the abstract
Hazard ratio
0.77
95% CI 0.68–0.87
P < 0.001
SGLT2i vs Non-users
HR 0.77 (95% CI 0.68–0.87); P < 0.001
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Ischaemic stroke · matched cohort | 0.67 (0.60–0.75) | P < 0.001 | |
| ESKD · matched cohort | 0.75 (0.63–0.89) | P = 0.001 | |
| 0.512Hazard ratio (log scale) |
Alzheimer's disease
- Risk reduced, HR (SGLT2i vs non-users)
- HR 0.58, 95% CI 0.45-0.74; P < .001
- matched cohort
Vascular dementia
- Risk reduced, HR (SGLT2i vs non-users)
- HR 0.41, 95% CI 0.27-0.62; P < .001
- matched cohort
All-cause mortality
- Risk reduced, HR (SGLT2i vs non-users)
- HR 0.63, 95% CI 0.61-0.66; P < .001
- matched cohort
Original publication
Association of SGLT2 inhibitors and new-onset dementia in non-diabetic patients with heart failure. Eur J Heart Fail. Published 10 February 2026. doi:10.1093/ejhf/xuag038
Summarised from the published abstract; every number is checked against it