Common pill taken by millions could ‘slash your risk of dementia and dying young’

A CHEAP pill already taken by millions of patients could slash your risk of dementia and early death, scientists say.

This is none other than metformin, “the most widely prescribed drug for type 2 diabetes”, according to researchers from Taipei Medical University in Taiwan.

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Diabetes pill metformin could lower the risk of dementia and deathCredit: Alamy

They found that people who were taking the treatment were less likely to develop memory-robbing dementia or die from any cause.

The results were based on a study of 452,777 adults who were either overweight or obese, published in Diabetes, Obesity and Metabolism.

Obesity and diabetes have both been shown to up the risk of dementia.

Some studies report that diabetics have a 70 per cent higher risk of getting the condition, compared to those without diabetes.

Meanwhile, being obese between the ages of 35-65 can increase dementia risk in later-life by about 30 per cent.

Metformin is the most common treatment for type 2 diabetes, which affects over 5 million Brits, according to Diabetes UK.

The drug is also used to help prevent type 2 diabetes in people at high risk of developing it.

It works by curbing the amount of sugar pumped around the body by the liver and helping the insulin you produce work better.

“Metformin has many advantages over other diabetic drugs. It has strong glucose-lowering effects, a reliable safety profile and is relatively cheap,” researchers said.

“Metformin also reduces the likelihood of dementia in patients with diabetes.”

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But some studies suggest the drug doesn’t protect against dementia, as it can cause vitamin B12 deficiency, which has been linked to cognitive decline.

It could increase the risk of Alzheimer’s, a type of dementia, research suggests.

“Whether metformin’s beneficial effects in patients with dementia can be applied to the general population is unclear,” the study authors noted.

The study included about 905,000 people in total, split evenly into two groups: metformin users and non-metformin users.

They were matched to be similar in age, health, and other factors for a fair comparison.

The metformin group had been prescribed the drug at least twice in their lives, for at least six months.

Researchers categorised study participants by their body mass index (BMI) as:

  • Overweight: BMI 25–29.9
  • Obese class I: BMI 30–34.9
  • Obese class II: BMI 35–39.9
  • Morbidly obese: BMI over 40

They followed patients for 10 years and found that those who took metformin had a lower risk of developing dementia, regardless of their BMI.

Class I and II obese patients saw the greatest reduction in risk – 8 and 4 per cent respectively, compared to people who didn’t take metformin.

Ways to lower dementia risk with type 2 diabetes

Manage blood sugar levels

  • Strictly follow a diabetes management plan, as prescribed by a healthcare professional. This includes medication, diet and exercise.
  • Regularly monitor blood sugar levels and manage insulin appropriately.

Adopt a healthy lifestyle

  • Follow a balanced diet in fruits, vegetables, whole grains, and lean protein, with limited saturated fat, sugar, and salt.
  • Aim for at least 150 minutes of moderate-intensity exercise per week.
  • Being overweight or obese can increase the risk of type 2 diabetes and other conditions linked to dementia. Weight management through diet and exercise can help mitigate these risks. 
  • Engage in activities that challenge your mind, such as puzzles, reading, learning new skills, or socialising.

Address other risk factors

  • High blood pressure and cholesterol can damage blood vessels, increasing the risk of both cardiovascular disease and dementia. Regular check-ups and appropriate treatment are essential. 
  • Excessive alcohol consumption can negatively impact brain health. Moderate drinking or abstaining from alcohol can be beneficial. 
  • Hearing loss can contribute to cognitive decline. Addressing hearing problems through hearing aids or other interventions can help maintain cognitive function. 

Seek professional guidance

  • Regular medical check-ups are important for monitoring overall health and identifying and addressing potential risk factors early on. 
  • Work with your doctor, diabetes educator, or other healthcare professionals to develop a personalized plan for managing your diabetes and reducing your risk of dementia.

Researchers said the drug’s ability to lower inflammation in obese patients may have something to do with this.

“Since central nervous system inflammation and neuroinflammation are crucial factors in the development and progression of neurodegenerative diseases, the anti-inflammatory and antioxidative effects of metformin are especially beneficial in patients with obesity,” they wrote.

“We observed that the protective effect of metformin against dementia was consistent across all BMI categories greater than 25.”

Metformin-users also had a lower risk of early death, between 28 and 26 per cent.

“This study is strong because it included a large sample of metformin users and patients with obesity and dementia, using data from more than 184 million patients worldwide,” researchers said.

“The use of real-world data allows for a better understanding of how treatments perform in a heterogeneous population because the data are captured from diverse, real-life settings.

“Therefore, the findings of this study can be readily generalised to whole populations.”

But they acknowledge that their study had certain limitations too, including that the dataset only covered a 10 year period, restricting researchers’ ability to evaluate the long-term effects of metformin.

They concluded: “Our study findings indicate that metformin may help reduce the risk of dementia in obese patients, which could further contribute to improving all-cause mortality.

“However, further research is required to explore the mechanisms by which metformin reduces the risk of dementia.”

Experts have previously suggested that using metformin to help treat dementia could cut costs.

Dr Sara Imarisio, who used to be head of research at Alzheimer’s Research UK, said: “Repurposing an existing drug used for another health condition would be a cheaper and inexpensive way to bring about a new dementia treatment.

“Diabetes is a risk factor for dementia and there is a lot of interest in the links between the two conditions.”

But recent research suggests that weight-loss jabs are better at curbing dementia risk in people with type 2 diabetes than metformin.

Metformin is generally the first-line medication for type 2 diabetes, while GLP-1 receptor agonists are often used as second-line or add-on therapy when metformin is not sufficient or tolerated.

Early signs of dementia

It’s not unusual for your memory to lapse a bit as you get older.

But dementia is different from ‘just getting old’ as it will cause noticeable – rather than gradual – changes to mental abilities and make managing everyday tasks and activities increasingly difficult.

The symptoms of dementia may be small to start with, but get worse over time.

Below are some examples of possible signs.

Memory loss

Memory loss is a key sign of dementia. This can include:

  • Forgetting something you were only recently told. You may ask for the same information repeatedly – for example, ‘Are the doors locked?’
  • Putting objects in unusual places – for example, putting your house keys in the refrigerator.
  • Being unable to learn new tasks, like how to use a new washing machine.

Planning and decision making issues

People with dementia can have difficulty with planning and decision making. This can include:

  • Getting very confused when planning or thinking things through.
  • Struggling to stay focused on a single task.
  • Not making informed, careful decisions when dealing with money or looking at risks.
  • Finding it hard to manage regular payments, budgets or monthly bills.

Problems with language and understanding

In people with dementia, this can manifest as:

  • Having frequent problems finding the right word or regularly referring to objects as ‘that thing’.
  • Finding it hard to take part in conversations.
  • Regularly being unable to follow what someone is saying even without distractions.

Losing sense of time and place

Dementia can cause problems with orientation, including:

  • Losing track of the date, season or the passage of time.
  • Getting lost in a place that is familiar or that should be easy to find your way around – for example, a supermarket.
  • Regularly being unable to follow what someone is saying even without distractions.

Problems with vision and perception

This can mean having problems making sense of what you see.

For example, having difficulty judging distances on stairs, or mistaking reflections or patterns for other objects.

Mood and behavioural changes

Finally, dementia can also make people act differently or shift their mood. This can mean:

  • Becoming withdrawn and losing interest in work, friends or hobbies.
  • Feeling unusually sad, anxious, frightened or low in confidence.
  • Getting easily upset at home, at work, with friends or in places that usually feel comfortable or familiar.

Source: Alzheimer’s Society

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