Insulin resistance may hold the key to Alzheimer's disease

According to Alzheimer's Research UK (Jones, 2024), in 2024 the number of people living with dementia in the UK was estimated to be almost 1 million (982 000), and by 2040 this could rise to 1.4 million; in 2022, the leading cause of death in the UK was dementia, claiming over 74 000 lives; and in 2024 the economic impact of dementia in the UK was an estimated £42.5 billion.

Among hypotheses listed by Agarwal et al (2021) are:

It appeared promising with the publication of the findings of an 18-month, double-blind, phase 3 trial involving individuals with early Alzheimer's disease in November 2022 (van Dyck et al, 2022). Half of the 1795 participants received lecanemab, a monoclonal antibody that binds to soluble Aβ protofibrils. A BBC News story announced: ‘Alzheimer's drug lecanemab hailed as momentous breakthrough’ (Gallagher, 2022).

However, the findings of the trial should be taken with caution: ‘… lecanemab made a tiny difference to cognitive deterioration on cognition scales over 18 months, which although statistically significant may not be clinically significant …’ Kmietowicz (2022). The researchers themselves stated that the drug gave ‘moderately less decline on measures of cognition and function than placebo at 18 months but was associated with adverse events’ (van Dyck et al, 2022).