We uncover a fascinating dichotomy: a vast array of real-world observational data, encompassing hundreds of thousands of patients, consistently points toward a significant neuroprotective effect, suggesting that SGLT2 inhibitor use is associated with a markedly lower risk of dementia compared to other antidiabetic therapies such as dipeptidyl peptidase-4 (DPP-4) inhibitors or sulfonylureas. Here, DPP4 is linked to dementia.