Two widely available medicines can safely improve brain health in those with early Alzheimer’s disease, a new study has found.
Scientists found that the diabetes drug empagliflozin and an intranasal insulin spray have promising effects on memory, brain health, and brain blood flow, according to research published in the journal Alzheimer’s & Dementia.
These findings can address a critical treatment gap for patients with Alzheimer’s disease. While recently approved Alzheimer’s drugs represent progress, scientists say their benefits are modest and these medications are also unavailable to many patients due to their side effects.
These drugs also do not appear to address the brain blood flow problems that drive Alzheimer’s progression or help restore brain function after damage occurs, according to researchers from the Wake Forest University School of Medicine.
“For the first time, we found that empagliflozin, an established diabetes and heart medication sold under the brand name Jardiance, reduced markers of brain injury while restoring blood flow in critical brain regions,” said Suzanne Craft, an author of the study from the Wake Forest University School of Medicine.
“We also confirmed that delivering insulin directly to the brain with a newly validated device enhances cognition, neurovascular health and immune function,” Dr Craft said.
These findings, according to researchers, highlight brain boosting metabolism as a powerful approach in Alzheimer’s treatment.
“A longer and larger trial is needed to confirm these results,” scientists wrote.
In the four-week clinical trial, doctors enrolled 47 older adults of an average age of 70 with mild cognitive impairment or early Alzheimer’s disease.
The participants were randomly assigned to receive intranasal insulin alone, empagliflozin alone, both medications together, or a placebo.
Researchers observed that both medications were safe and well-tolerated with treatment-related side effects being mild and similar across all groups.
They found that each medicine had different benefits with the insulin nasal spray use linked to improved performance on cognitive tests that detect early memory changes, while empagliflozin lowered tau protein in spinal fluid, which is linked to toxic lumps in Alzheimer’s patient brains.
These changes hint at the drugs activating protective immune responses and reducing harmful inflammation.
The nasal spray uses a precision delivery device to send insulin directly into the brain via the nose, bypassing the bloodstream.
Once there, insulin activates proteins throughout the brain that keep nerve endings healthy, support blood vessel function, and regulate immune responses.
Previous research has shown that Alzheimer’s disease patients often have insulin resistance in the brain alongside blood vessel problems that reduce nutrient delivery.
“We plan to build on these promising results with larger, longer studies in people with early and preclinical Alzheimer’s disease,” Dr Craft said.
“Because empagliflozin or intranasal insulin improved tau tangles, cognition, neurovascular health and immune function, we believe these treatments could offer real therapeutic potential, either on their own or in combination with other Alzheimer’s therapies,” she added.
