Ozempic's Next Off-Label Usage Could Be in Treating Alzheimer’s
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After making headlines as a miracle weight loss drug, Ozempic is back in the news. This time, the diabetes medication is under study for its potential to treat Alzheimer’s disease.
“Alzheimer’s disease has also been called ‘diabetes type-III,’ so it is hopeful that in mild cognitive impairment or early-stage Alzheimer’s disease, patients with metabolic syndrome including insulin resistance or frank diabetes will benefit from treatments for diabetes like the GLP-1 agonists,” David Merrill, M.D., Ph.D., an adult and geriatric psychiatrist at Pacific Brain Health Center in Santa Monica, told Healthline. “These drugs show great promise in slowing or preventing onset of cognitive decline in those at risk for Alzheimer’s disease.”
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Alzheimer’s is one of the hardest neurological disorders to manage. About 6.7 million Americans 65 years and older live with Alzheimer’s—and this number is growing fast. A 2022 study predicts an estimated 153 million people worldwide will develop Alzheimer’s by 2050. Yet despite the alarming rate of cases, scientists have had little headway in finding a cure.
It’s difficult to pinpoint a single cause of Alzheimer’s and create an effective treatment around it. But neuroscience researchers hope that Ozempic’s versatility as a drug could help slow down cognitive decline in multiple ways.
How does Ozempic work?
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The injectable drug is FDA-approved to help adults with type 2 diabetes improve their blood sugar levels. It mimics a gut hormone called GLP-1 and binds to its receptor. This interaction signals the pancreas it’s time to release insulin, allowing blood sugar to go down. But one of the side effects of this receptor activity is that it slows down how fast food moves through the digestive tract, leaving you with a feeling of fullness.
It’s the satiety side-effect that pushed Ozempic into TikTok stardom as a miracle diet hack. The drug went viral with the hashtag #Ozempic, garnering over 600 million views. Adding to the hype were celebrities like Kim Kardashian and Mindy Kaling, who are speculated to have used Ozempic to lose a dramatic amount of weight in a short period. Even Elon Musk jumped on the trend and publicly credited it on Twitter for helping him get fit. Ozempic became so high in demand it caused a global drug shortage, with diabetic users feeling the full brunt of it.
Three ways Ozempic might help with Alzheimer’s disease
Insulin resistance
One theory is that insulin resistance causes Alzheimer’s since impaired sugar metabolism is usually a sign of disease. Normally, insulin reduces blood sugar levels by moving glucose from the blood into cells. The glucose is then converted into energy for cells to use. When insulin signaling is impaired, cells are essentially starved from being unable to take in glucose.
With glucose as the primary energy source for the brain, it won’t be able to function properly. Disruptions in metabolic processes could then drive the clumping of amyloid-beta plaques that kill brain cells. In support of this theory, more studies have found insulin resistance and low glucose metabolism in the brain as good predictors of memory problems in midlife.
Ozempic could help deliver insulin to this glucose-starved organ. What’s more, Ozempic might not even need to cross the blood-brain barrier—the brain’s ultimate defense against bacteria, viruses, and other dangerous toxins. However, a 2023 study published in Brain found insulin receptors outside the blood-brain barrier.
“Before this study, the accepted view was that insulin crossed the blood-brain barrier to act mainly on neurons and astrocytes,” Frederic Calon, Ph.D., a biochemist-pharmacist at Laval University in Canada, told Fierce Biotech. “We were surprised to detect that only a very small amount of insulin is actually transported across the blood-brain barrier.” The findings open the way for all kinds of diabetic drugs like Ozempic to be tested as part of an Alzheimer’s treatment regimen.
Inflammation
One effect of Alzheimer’s is chronic inflammation in the brain. Researchers have found elevated inflammation levels in people with Alzheimer’s, and this may have a hand in creating amyloid-beta plaques. Additionally, high levels of inflammation can damage the blood-brain barrier—a sign of Alzheimer’s—and make it harder for the brain to filter out toxins.
Research shows Ozempic is effective at dampening inflammation in the body, so it wouldn’t be too much of a stretch to find it can do the same in the brain.
Amyloid-beta clumps
A hallmark of Alzheimer’s is the buildup of sticky plaques in the brain. As more clump together between neurons, they might trigger an immune response that causes surrounding cells to die. Additionally, tangles inside cells can block nutrient processes, starving neurons.
Since GLP-1 receptors are in the brain, Ozempic may somehow change brain activity and slow down the development of the disease. There is even some research to suggest Ozempic could reduce amyloid-beta plaques, even if scientists don’t completely understand how. For example, the authors of a 5-year study observed lower rates of dementia in people with type 2 diabetes taking Ozempic than those that did not.
Two clinical trials, both launched in 2021, are studying how daily doses of Ozempic affect cognition in people with early Alzheimer’s. The trials will run for three years.
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