A medication commonly prescribed for diabetes and weight loss, liraglutide, has been found to significantly reduce brain shrinkage in patients with Alzheimer’s disease.
Liraglutide is part of a group of drugs called glucagon-like peptide receptor (GLP-1) agonists, which includes well-known medications like semaglutide, marketed as Wegovy or Ozempic.
These drugs are primarily used to manage overweight and obesity and treat type 2 diabetes. However, scientists are now exploring additional benefits of these medications.
In a study led by Professor Paul Edison at Imperial College London, involving 200 patients with Alzheimer’s disease, those who took liraglutide showed much less brain shrinkage and slower cognitive decline compared to those who received a placebo.
The study used brain imaging to observe the frontal, temporal, and parietal lobes, as well as the total gray matter, which are crucial areas for memory, learning, language, and decision-making—functions typically affected by Alzheimer’s.
The research, presented at the Alzheimer’s Association International Conference (AAIC 2024) in Philadelphia, suggests that liraglutide may protect the brains of people with mild Alzheimer’s disease. After one year of treatment, patients who took liraglutide experienced an 18% reduction in cognitive decline compared to those on the placebo.
Although the exact mechanism of how liraglutide works on the brain is not fully understood, researchers believe its benefits may stem from its ability to reduce inflammation, insulin resistance, and tau protein aggregation, which are all linked to Alzheimer’s progression.
Professor Edison explained that liraglutide might protect the brain by improving communication between nerve cells and reducing the toxic effects of Alzheimer’s-related biomarkers. This action is similar to how statins protect the heart by lowering cholesterol levels.
Brain shrinkage is a common symptom of Alzheimer’s disease, where damage spreads through the brain, causing it to gradually lose volume. In the randomized, double-blind, placebo-controlled trial, 204 patients with mild Alzheimer’s were recruited from 24 clinics across the UK.
Half of the participants received a daily injection of up to 1.8 mg of liraglutide, while the other half received a placebo. Before the study began, all participants underwent brain MRI scans to assess structure and volume, glucose metabolism PET scans, and detailed memory tests. These tests were repeated at the study’s conclusion.
Although the primary goal of the study, which focused on changes in brain glucose metabolism, was not achieved, the secondary goals showed significant improvements. These included clinical and cognitive measures and brain volume changes.
Patients who received liraglutide had nearly 50% less brain volume loss in several areas as measured by MRI. Cognitive testing also revealed that those on liraglutide had an 18% slower decline in cognitive function over one year compared to the placebo group.
Professor Edison noted that since liraglutide and other GLP-1 analogs are already approved for managing obesity and diabetes, they could quickly become available for treating Alzheimer’s if further research confirms their effectiveness.
He added that if phase 3 trials, which are already underway, demonstrate similar results and receive FDA approval, liraglutide could be rapidly deployed as a treatment for Alzheimer’s disease. Results from these trials are expected by the end of 2025.
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