The rate of incident AD was assessed in individuals taking an SGLT2 inhibitor versus a DPP-4 inhibitor. When comparing SGLT2 inhibitors with DPP-4 inhibitors, SGLT2 inhibitors had a lower risk of dementia (14.2/1000 person-years; aHR 0.80 [95% CI 0.71–0.89]). Dapagliflozin exhibited the lowest risk (aHR 0.67 [95% CI 0.53–0.84]), followed by empagliflozin (aHR 0.78 [95% CI 0.69–0.89]), whereas canagliflozin showed no association (aHR 0.96 [95% CI 0.80–1.16]). This evidence concerns the gene DPP4 and Alzheimer disease.