Real world impact of glucagon-like peptide receptor agonist (GLP-1 RA) use on older adults

Use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is rapidly increasing throughout the US population, particularly in older adults (≥60 years). It has been estimated that 26.8 million adults insured by Medicare alone are eligible for a GLP-1 RA prescription. Clinical trial data indicate that these medications are effective in older adults, but clinical trial populations frequently differ from patients in general clinical practice. As GLP-1 RAs move from clinical trials into primary care and community medical practices, the effects of these medications on the general aging population are unclear. The sheer number of older adults who may eventually be prescribed a GLP-1 RA makes it necessary to determine whether these medications are as safe and effective in general practice as in carefully controlled clinical trials. To address this gap, we will use linked electronic health records (EHR) available from the Rochester Epidemiology Project (REP) research infrastructure to study age differences in response to GLP-1 RAs in a large, population-based cohort of persons living in the upper midwest (n=26,442). Specifically, we will test the following hypotheses: Aim 1. We hypothesize that older adults will have a shorter prescription duration and fewer prescription changes, but a similar total percent body weight loss compared to middle-aged adults. Aim 2. We hypothesize that older adults will be more likely to discontinue GLP-1 RAs and will experience more side effects than middle-aged adults. Aim 3. We hypothesize that risk of pancreatitis, bowel obstruction, interstitial nephritis, falls, fractures, and frailty will be higher in older persons prescribed GLP-1 RAs compared to propensity weighted persons who are not prescribed these medications. In summary, as GLP-1 RAs are increasingly prescribed to aging adults, our studies will provide essential data to better understand the risk/benefit profile of these medications in a real- world setting. Project Number: 1R21AG097887-01 | Fiscal Year: 2026 | NIH Institute/Center: National Institute on Aging (NIA) | Principal Investigator: JENNIFER ST SAUVER | Institution: MAYO CLINIC ROCHESTER, ROCHESTER, MN | Award Amount: $443,850 | Activity Code: R21 | Study Section: Aging, Injury, Musculoskeletal, and Rheumatologic Disorders Study Section[AIMR] View on NIH RePORTER: https://reporter.nih.gov/project-details/11283719