Effect of Insulin Sensitizer Metformin on AD Biomarkers
Status:
Completed
Trial end date:
2017-04-01
Target enrollment:
Participant gender:
Summary
Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive loss of
memory and other cognitive functions. It is the most common cause of dementia in older
adults, affecting approximately 18 million people worldwide, including almost 500,000 in the
Philadelphia tri-state area. After age 65, the incidence of AD rises exponentially, doubling
every five years. By age 85, almost half of us will have AD. In 2030, as many as 7.7 million
Americans could have AD, and by 2050 this number could rise to 11-16 million people. The
annual cost of AD in the United States is about $200 billion. AD-related medical
complications are among the most common causes of death in the elderly population. Despite
these alarming statistics, a "cure" for AD may not be essential since delaying the onset of
AD by just 5 years could have a profound impact on this disorder by reducing the incidence
and cost of AD by 50% between now and 2050.
AD is difficult to recognize in its earliest stages, in which the principal complaint is
typically an increase in episodes of forgetfulness. This stage is now commonly referred to as
mild cognitive impairment (MCI). Neuroimaging and CSF biomarkers have demonstrated good
accuracy in predicting which MCI patients later "convert" to AD and which tend to remain
stable or revert to more normal cognition. The diagnosis of AD itself is made when increased
loss of memory and other cognitive abilities (eg, language, praxis, and executive function)
affect daily functioning. As the symptoms of dementia inevitably worsen, patients may become
incapable of even basic activities such as feeding and dressing themselves. The disease
course often spans more than a decade, creating a vast social and financial burden on society
and extracting an immeasurable emotional toll on family members.
Clinical and preclinical evidence is accumulating that brain insulin resistance may play a
role in the pathogenesis and/or progression of Alzheimer's disease and that ameliorating
insulin action in the brain may benefit cognition symptomatically and modify disease
pathology.