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Drugs (2022) 82: 121320

Patrick Wingrove

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Practical considerations for patients include: Continue evidence-based Alzheimer's prevention strategies, including cardiovascular risk factor management, regular physical activity, cognitive engagement, social connection, and a heart-healthy diet such as the Mediterranean or MIND diet Maintain optimal control of diabetes and metabolic conditions, as these are established risk factors for cognitive decline regardless of specific medication choices Discuss any cognitive concerns with healthcare providers promptly, as early evaluation and intervention for memory problems can be beneficial Recognize that managing diabetes effectively with any appropriate medication likely provides some cognitive benefit compared to poorly controlled diabetes Red flags requiring urgent medical evaluation include: Sudden confusion or altered mental status Rapid cognitive decline over weeks to months New focal neurological symptoms (weakness, speech changes, vision changes) Falls or loss of consciousness If cognitive concerns arise, patients should typically start with their primary care provider, who may perform initial cognitive screening and laboratory tests to rule out reversible causes before considering referral to neurology, geriatrics, or a memory disorders clinic

27 However, dedicated trials involving both SGLT-2 inhibitors and mineralocorticoid receptor antagonists are required to demonstrate the true benefits of combining these two classes of medications

Some people maintain 90% of their weight loss