Heart failure & cardiomyopathies

Association of SGLT2 inhibitors and new-onset dementia in non-diabetic patients with heart failure

Eur J Heart FailPublished Retrospective cohort study

Main finding · New-onset dementiaResult — go to the resultHazard ratio 0.77 95% CI 0.68–0.87

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
Methodological detailspropensity-score matched
  • Propensity-score matched

Main finding

As reported in the abstract

Hazard ratio

0.77

95% CI 0.68–0.87

P < 0.001

SGLT2ivs Non-users
HR 0.77 (95% CI 0.68–0.87); P < 0.001

Observational data: associations, not effects.

Secondary outcomes

OutcomeHR (95% CI)P value
Ischaemic strokeMatched cohort0.67 (0.60–0.75)P < 0.001
ESKDMatched cohort0.75 (0.63–0.89)P = 0.001

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

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