Emerging evidence suggests metabolic pathways play significant roles in neurodegeneration. This retrospective cohort study of 1.2 million individuals assessed whether GLP-1 receptor agonist use was associated with reduced Alzheimer's disease incidence. Over 10 years of follow-up, GLP-1RA users had a 39% lower risk of AD diagnosis (HR 0.61, 95% CI: 0.54–0.68). This association persisted across age groups, sex, and baseline metabolic status, suggesting a potential neuroprotective mechanism warranting further investigation.