Metformin against dementia
Diabetes drug suspected of reducing dementia risk
Elizaveta Ivtushok, N+1
The drug metformin, used to reduce blood sugar in type 2 diabetes, may reduce the risk of developing dementia in old age. This was found out by Australian scientists: among the participants in their study with diabetes, dementia was diagnosed five times less often to those who took metformin. The discovered link was not affected by side variables (including the genotype providing an additional risk of developing dementia), but for accurate conclusions and understanding of the mechanism, additional research is necessary, the scientists write in the journal Diabetes Care.
Type 2 diabetes is often associated with an accelerated process of neurodegeneration: studies show that people with this disease have a higher risk of developing Alzheimer's disease and dementia outside of it. In particular, the risk of vascular dementia is high – it is directly related to the dysfunction of cerebral blood flow.
Patients with type 2 diabetes, therefore, are in a special risk group – and it is better for them to start prevention of neurodegeneration as early as possible. One of the most popular drugs for lowering blood sugar, metformin, can help in this: in addition to its main function, it (in combination with blood pressure medications) it has an anti-cancer effect, and also restores stem cells in the brain (although this particular effect is weakened by testosterone).
At the same time, there is still insufficient data that would confirm the benefits of metformin in the prevention of dementia (especially in the population). Katherine Samaras from the University of New South Wales and her colleagues decided to supplement the available data with the results of a long-term study of memory and aging (Sydney Memory and Aging Study), which has been held in Sydney since 2005: 1037 people aged 70 to 90 years take part in it.
Participants, none of whom had dementia or other diagnosed neurodegenerative diseases at the beginning of the study, were interviewed and examined every two years; in addition, each of them underwent tests to assess the rate of cognitive decline. Data on gender, age, body mass index, chronic diseases (e.g., heart and vascular problems), smoking, alcohol consumption and the presence of a variant of the APOE gene, which is associated with an increased risk of dementia, were available for each of the participants.
Of all the participants, 123 people were diagnosed with diabetes at the initial stage of the study: slightly more than half (67 participants) of them took metformin. Participants with diabetes who did not take metformin were diagnosed with dementia significantly (about five times) more often (p=0.05) during the entire observation period than those who took the drug; also, patients who took metformin performed better on cognitive tests. This dependence was not explained by side variables – gender, age, genotype and aspects of lifestyle and health of participants.
The authors thus showed that metformin can actually reduce the risk of dementia in elderly patients with diabetes. In the near future, they are also going to start a long-term randomized study, with the help of which the connection can be established more accurately (and also, possibly, its causality can be assessed).
In addition, it remains unclear exactly how metformin helps to maintain mental clarity. Probably, it may be a restorative effect for cells: studies show that the drug activates progenitor cells, which can help in restoring brain function.
Last year, with the help of metformin and hormonal drugs, scientists managed to improve the work of the thymus (the organ responsible for the production and operation of T-lymphocytes), and at the same time – for the first time to reduce the biological age of a person.
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