Chronic disease and aging are related. The same molecular biology that causes aging also causes chronic disease. This site is all about that relationship and how we can modify it. The disease that I fear most is dementia. Losing the ability to recognize the people I love and manage my own affairs is my worst nightmare. Friday night, I realized that I had not seen anything on the impact of optimal medical therapy (OMT) on Alzheimer’s and other dementias. So, I began to look for it. I did not find anything on OMT benefits for dementia, but I did find something on one of the key medications. Metformin reduces the risk of dementia.
“Older people taking metformin, the first-line treatment for type 2 diabetes, show significantly lower rates of dementia and cognitive decline compared to those with diabetes not receiving the drug, with the former having dementia rates that are, in fact, similar to people without diabetes, new research shows.”
Older patients with diabetes have a sixty percent risk of developing dementia. In this study, 8% of patients without diabetes developed dementia. 14% of patients with diabetes not taking metformin had this complication and only 6% of patients with diabetes on metformin. Metformin treatment reduced this complication by over half. This is a very important issue because so many older Americans have type 2 diabetes and too few are on metformin.
So, metformin reduces dementia. The next question is why? In every other chronic condition I have investigated, I have found that the master metabolic switches mTOR and AMPK are central to the biology. It is no different with Alzheimer’s disease. Altered tau proteins are key factors in developing this disease. mTOR-related signaling regulates tau protein formation and alteration. mTOR activity is increased in the area of Alzheimer’s lesions, and “mTOR mediates the synthesis and aggregation of tau, resulting in compromised microtubule stability”. Switching on the master metabolic switch mTOR inappropriately is a central part of Alzheimer’s disease. Based on this information, we could also predict that optimal medical therapy would provide even more benefit than metformin alone.
Metformin directly inhibits mTOR. It is like a laser. That is the central effect of the drug, just as we discussed with the medications like Jardiance or empagliflozin. It probably has very little to do with lowering the sugar. Empagliflozin, by activating AMPK, also switches off mTOR. Lisinopril, losartan, statins, metformin, and spironolactone do the same thing and the core drugs can be purchased for pennies a day. These interventions protect every cell and organ in the body. They slow aging.
This has happened to me over and over with chronic diseases including cancer. I have yet to find an exception to this rule. When I look for relationships between the diagram and chronic illness, I find it. The signaling in the diagram above is involved and we have precision interventions already that modify it in a potent way. These medications are antioxidants that work. We could be healthier longer now for less money. Let’s get started.
Agreed!