A UT Southwestern study published October 7, 2026 in Diabetes, Obesity and Metabolism compared 73,592 matched pairs of veterans with type 2 diabetes who started a GLP-1 drug or a DPP-4 inhibitor, an older diabetes pill, between 2006 and 2021. Over about 27 months, the GLP-1 group had a 13% lower fall rate (incidence rate ratio 0.87) and slightly less worsening on a frailty index. The link weakened in people who were already severely frail, and the observational design cannot prove the drugs caused the difference.
US data-analytics firm nference published a real-world evidence analysis this week that compared frailty-related outcomes across three cohorts of US adults 65 and older: nearly 30,000 patients treated with Zepbound (tirzepatide) for obesity, nearly 19,000 receiving non-GLP-1 drugs for type 2 diabetes, and nearly 6,000 who underwent weight-loss surgery. Health records showed progressive declines in muscle mass and function developed in 0.16% of patients across the analysis, malnutrition in 1.6%, dehydration in 3%, and loss of appetite in 4.75%. Lead author Soundararajan's team focused on Zepbound because prior analyses linked tirzepatide with more weight and muscle loss than semaglutide (the active ingredient in Novo Nordisk's Wegovy and Ozempic). The authors said results should not discourage appropriate use of Zepbound or Wegovy in older adults and encouraged closer follow-up of older patients on GLP-1 therapy. The findings arrive as the Medicare GLP-1 Bridge (launched July 1, 2026) expands GLP-1 access to Part D beneficiaries and as prescribers weigh muscle-preservation strategies including selective androgen receptor modulators (SARMs) like Veru's enobosarm and myostatin inhibitors.