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Results: We show that semaglutide was associated with a significantly reduced risk of overall ADRD incidence with a hazard ratio ranging from 0.54 (0.490.59) compared with insulin, 0.67 (0.610.74) compared with metformin, to 0.80 (0.720.89) compared with older generation glucagon-like peptide-1 agonists (GLP-1RAs)