Metformin for dementia: Could a diabetes drug slow cognitive decline?

  • Dementia is a condition that impacts people’s thinking and memory and can be debilitating as the disorder progresses.
  • Conditions like diabetes can increase someone’s risk of developing dementia.
  • Researchers have been looking for ways to prevent dementia and slow symptoms of cognitive decline.
  • A​ phase 3 clinical trial is seeking to understand if doctors could use metformin, a drug prescribed to treat diabetes, as a treatment option to slow cognitive decline, even among people who don’t have diabetes.

Treatment for diseases and conditions has expanded dramatically in the last few decades. However, some disorders are still difficult to manage. Dementia is one condition that continues to get progressively worse, and options to slow the associated cognitive decline are limited.

Researchers with the Garvan Institute of Medical Research are looking into how the medication metformin could be used to slow the progression of cognitive decline.

They recently launched a phase 3 clinical trial and are now seeking more participants to expand their data collection.

Dementia’s impact

Dementia encompasses a variety of symptoms that impact people’s memory and thinking abilities. It reaches a point where people have difficulty completing everyday activities. The specific manifestations of dementia will depend on the type of dementia.

Dr. Verna Porter, a neurologist and director of the Dementia, Alzheimer’s Disease and Neurocognitive Disorders at Providence Saint John’s Health Center in Santa Monica, CA, who is not involved in the current trial, explained to Medical News Today:

“Dementia is characterized by marked, persistent, and disabling decline in two or more intellectual abilities, such as memory, language, judgment, or abstract reasoning, that significantly interfere with and disrupt your normal daily activities.”

Diabetes as a risk factor for dementia

Certain risk factors can put people at a greater risk of developing dementia.

For example, obesity, high blood pressure, and diabetes are all modifiable risk factors that can increase someone’s risk of developing dementia.

The relationship between diabetes and dementia has influenced research on how metformin, a diabetes treatment medication, could slow cognitive decline.

U​sing metformin to improve cognitive decline

Doctors commonly prescribe metformin to help in the management of type two diabetes. But there may be other uses for this medication as well.

Metformin, taken as an oral tablet or solution, works by reducing the amount of glucose (sugar) made by the liver, decreasing the amount the body absorbs, and increasing the effect of insulin—a hormone that helps regulate the amount of blood sugar. It was approved by the FDA in 1994.

“Studies have shown that use of metformin for type 2 diabetes significantly reduces the risk of dementia among men in certain racial and age groups,” Dr. Porter noted.

Previous research from the Garvan Institute of Medical Research found that the use of metformin in people with type 2 diabetes was linked with slower cognitive decline and lower rates of dementia. This study and previously available data have paved the way for the current phase 3 clinical trial called the MetMemory Study.

One of the major players in the MetMemory study, Professor Katherine Samaras, explained the trial’s goals and previous research:

“This trial will look at metformin’s impact on cognitive decline among participants who don’t currently have diabetes. They are seeking participants who meet specific eligibility criteria, including being over the age of sixty and not currently having dementia”.

The group notes, “Our aims are to slow loss of memory and other aspects of cognition with aging, and examine whether metformin affects other aspects of metabolism, inflammation and the aging process.”

When will patients get access?

T​he MetMemory study will take three years to complete.

The study’s results will inform the potential use of the treatment in clinical practice. F​or example, if the study shows that metformin is useful in slowing cognitive decline, doctors could potentially prescribe it as a preventive treatment option in the future.

Prof. Samaras was optimistic that results from this trial could translate quite quickly into direct clinical practice. This is partly due to how previous research has already demonstrated the safety of metformin. It is also a common medication that is readily available for use.

“The trial involves a three-year intervention using metformin. If the trial is successful in showing metformin slows cognitive decline, the results could be implemented with immediate translation. Metformin is already readily available on prescription. It is safe in most patient circumstances. Being off-patent, it is also very cheap. Therefore, if successful, we see immediate translation to clinical practice,” Prof. Samaras said.

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