Insulin resistance test may help predict early Alzheimer's cognitive decline rate
There is currently no tool for predicting how quickly early stage Alzheimer's disease will progress. A new study has identified a simple blood test used to measure insulin resistance that may also help doctors determine which people with early stage Alzheimer's disease are most likely to experience rapid cognitive decline. The test found that higher insulin resistance indicated quicker deterioration in cognitive decline.Researchers estimate that about 69 million people around the world are living with prodromal Alzheimer's disease, or early stage Alzheimer's disease. People in the earliest stage of Alzheimer's disease begin to experience some mild cognitive impairment that may affect their memory and ability to complete tasks and communicate. Past studies show that detecting Alzheimer's disease in its earliest stage allows currently available medications and lifestyle changes to be more effective in helping to slow down disease progression. 'Alzheimer's (disease) begins silently, often decades before symptoms appear, and so detecting risk early is essential to slow or alter the disease course,' Bianca Gumina, MD, a neurology resident for the Neurology Unit in the Department of Clinical and Experimental Sciences at the University of Brescia and for the Neurology Unit in the Department of Continuity of Care and Frailty at ASST Spedali Civili Hospital, both in Italy, told Medical News Today. 'Current tools can diagnose the disease, but they don't always predict how fast it will progress. Identifying individuals at higher risk of rapid decline [c]ould allow for timely, targeted interventions during a critical window when the disease could be still responsive to treatment or changes in (lifestyle),' she said.Gumina is part of the research team for a study recently presented at the European Academy of Neurology (EAN) Congress 2025 that has identified a simple blood test used to measure insulin resistance that may also help doctors determine which people with early stage Alzheimer's disease are most likely to experience rapid cognitive decline. The findings of the study are yet to be published in a peer-reviewed journal.The TyG Index Test for Alzheimer'sFor this study, researchers analyzed medical records from 315 adults with an average age of about 70 that did not have diabetes. Two hundred of the study participants had received biological confirmation they had Alzheimer's disease. All study participants received insulin resistance assessment using a test called the triglyceride-glucose (TyG) index, with a clinical follow-up three years later. 'The TyG index is a validated marker of insulin resistance, a condition often seen in prediabetes or metabolic syndrome,' Gumina explained. 'It combines triglycerides and fasting blood glucose, two common and non-invasive blood values. (It is) easy to calculate and already available in routine labs.' Higher TyG index results predict quicker cognitive declineAt the study's conclusion, the research team found that when grouping study participants by their TyG index results, those in the highest TyG index group experienced a quicker deterioration in cognitive decline than those with lower TyG index results. 4-fold higher risk'This finding is significant because it highlights a vulnerable window (mild cognitive impairment, the early phase of the disease) when the disease may be especially sensitive to metabolic stress. Patients in this early phase with high TyG levels had a fourfold increased risk of rapid cognitive decline compared to those with lower TyG levels. This suggests that insulin resistance may actively influence how fast Alzheimer's progresses, and identifying this risk early could open new avenues for intervention.'— Bianca Gumina, MD'The TyG index is a low-cost, widely available tool that could be easily integrated into routine clinical practice to flag patients at higher risk of rapid decline,' she continued. 'By identifying these individuals early, clinicians could prioritize them for closer monitoring, lifestyle interventions, or even enrollment in clinical trials, maybe individualizing sub phenotypes of the disease. It also supports the development of metabolic-based treatment strategies, potentially paving the way for therapies targeting insulin resistance to modify disease progression.'As for the next steps in this research, Gumina said the research group is currently exploring whether the TyG index also correlates with neuroimaging biomarkers of brain degeneration. 'The next goal is to integrate metabolic profiling with genetic and imaging data to refine risk models and guide early, personalized interventions,' she added. New potential variable for Alzheimer's progression predictionsMNT spoke with Rehan Aziz, MD, geriatric psychiatrist at Jersey Shore University Medical Center in New Jersey, about this study. Aziz commented that he thought this was a very interesting study involving a new variable to consider when working with patients in the early stages of Alzheimer's dementia, especially as it may predict who is likely to decline faster.'Accurate progression prediction is crucial for multiple reasons,' he explained. 'It empowers families to make informed decisions about care planning, financial arrangements, and how to prioritize quality time together. Clinically, it helps us identify patients who need more intensive monitoring and earlier intervention.''With new disease-modifying treatments like aducanumab and lecanemab becoming available — treatments that carry real risks including brain swelling and bleeding — we urgently need better ways to identify which patients are most likely to benefit from aggressive treatment versus those who might have slower progression,' Aziz continued.'This metabolic marker could help us personalize the risk-benefit calculation for each patient, ensuring we're offering these powerful but potentially risky therapies to those who need them most while protecting slower-progressing patients from unnecessary exposure.'— Rehan Aziz, MDAziz said he'd like to see this study's results validated in larger populations. 'We also need longer follow-up studies to see if this predictive power holds over five to 10 years,' he continued. 'I'm particularly interested in whether interventions targeting insulin resistance — like lifestyle modifications or medications like metformin — could actually slow progression in high-TyG patients. Finally, I'd like to see this integrated with other biomarkers to create a more comprehensive risk stratification tool.' More information on how Alzheimer's progressesMNT also spoke with Peter Gliebus, MD, director of cognitive and behavioral neurology at Marcus Neuroscience Institute, part of Baptist Health South Florida, about this research.Gliebus commented that he found the study both fascinating and highly applicable to daily clinical practice. 'As clinicians, we frequently encounter questions from patients and their families, such as, 'How quickly will it worsen?'— and we often don't have a definitive answer,' he explained. 'The prospect that a simple, cost-effective marker like the TyG index could predict progression in Alzheimer's disease is extremely encouraging. It has the potential to bridge an important gap between diagnosis and practical prognosis, which has been a missing element in this field,' he said.'Early-stage Alzheimer's, especially during the mild cognitive impairment stage, exhibits significant variability-some individuals remain stable for years, while others decline rapidly. Identifying those at higher risk of swift decline enables us to customize clinical care and research strategies. It also helps families set clearer expectations and facilitates early, potentially more effective interventions, whether through lifestyle changes, medications or future planning.' — Peter Gliebus, MD'As new treatments are developed, timing and patient stratification will be essential — tools like the TyG index may play a crucial role in that process,' he added.
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Telegraph
an hour ago
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Six life lessons from the healthiest town in Italy
On the west coast of Italy, just south of Naples, is the region of Cilento. It's known for its sprawling national park which overlooks the crystal clear Mediterranean Sea, yet its most impressive feature is its residents. A disproportionately high number of them – roughly 300, in fact – are over 100 years old, and in remarkable health, free of heart problems and mental ailments. Professor Salvatore Di Somma, founder of Great Health Science, which runs research programs investigating healthy ageing, has studied Cilento's residents for the past decade, alongside a team of scientists from Italy and the United States. He first visited the region in the late 1970s and, as a young doctor, was immediately enamoured with it. 'I was surprised to see people over the age of 90 still very healthy, with no cardiovascular disease, very active in mind, not even wearing glasses, and with well-functioning health systems,' he says. The researchers, collaborating under the CIAO (Cilento Initiative on Ageing Outcomes) study, believe Cilento should be designated an official ' Blue Zone '. 'It's a special place where people enjoy long and healthy lives with habits similar to residents in official Blue Zones, like Sardinia and Greece,' says Di Somma. 'There is a lot we can learn from them.' After ten years of research, he believes the team has only begun to uncover Cilento's secrets to robust ageing. But if we're not living in a beautiful Italian village by the sea, here's what else we can do. 1. Think of olive oil as medicine For Nicolina – a 101-year-old resident who lives in the mountainous village of Eremiti – her homemade olive oil is medicine. If she has a cold, her family physician will put a drop of it up her nose, and if she's constipated, she'll drink a spoonful of the golden liquid. It's a staple of the Mediterranean diet, and packed with antioxidants which are good for the gut and heart. In fact, Cilento is considered the birthplace of the Mediterranean diet – it's where Ancel Keys, the American physiologist, first discovered it in the 1950s, and made the link between certain dietary patterns and reduced cardiovascular risk. In 2022, Harvard researchers found that eating more than half a tablespoon of olive oil each day – especially in place of butter, margarine or mayonnaise – may boost longevity. They speculated this is due to olive oil's anti-inflammatory and antioxidant properties, which aid cardiovascular health and may reduce inflammation in the body. Di Somma and his team compared the health of middle-aged residents in Cilento to their counterparts in Malmo, Sweden. 'In north Europe they have totally different food habits and lifestyles. They use a lot of meat, and they use butter rather than olive oil,' he explains. In the study, they compared the lifestyle, dietary habits, and prevalence of cardiovascular disease and neurodegenerative biomarkers. Perhaps unsurprisingly, they discovered the residents in Malmo had a higher chance of cardiovascular disease and cancer, as well as higher LDL, bad cholesterol levels. The Mediterranean diet played a role in the better health of Cilento's residents, the researchers concluded, although they believed further protective factors were also at play. 2. Beef is off the menu but go big on the anchovies Carnivores, look away now. The residents of Cilento eat a very different diet to the average Westerner, explains Dr David Brenner, the president and chief executive of Sanford Burnham Prebys, a research unit working on the CIAO Study. Beef is rare – in fact, they don't eat much meat at all. Their diet centres around fruit, vegetables, nuts, legumes, and wholegrain breads and cereals. They flavour their meals with rosemary – healthy fats are key – and their preferred animal proteins are fish and seafood, particularly anchovies. Whilst we know red meat is a great source of protein and iron, it has also been linked to increased cancer risk. In 2019, Oxford University found that eating it just once a day could increase bowel cancer risk by a fifth. Meanwhile, although anchovies are more of an acquired taste, research consistently shows that they're good for the heart due to their omega-3 fatty acid content. 3. Cook, sing and pray to keep the brain active As Nicolina proves, many of the elderly residents in Cilento are mentally sharp. She perfectly remembers many of her friends who sadly died years ago and enjoys baking fresh cookies for her regular visitors. Meanwhile a fellow resident, 98-year-old Ida, who lives in the village of Gioi, makes her own fresh pasta and loves to sing. In fact, in 2020, the team studied the loneliness and wisdom of middle-aged and elderly people in Cilento compared with adults in San Diego, using two scientific scales. 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Garden and walk uphill to stay physically fit The land in Cilento is enviably rich and fertile whilst the villages are hilly, which means many residents simply spend their days gardening and incline walking. Exercise is therefore an integral and natural part of their lives. 'They produce a lot of their own vegetables which means they learn to garden from a young age and keep doing it as they get older. It's part of their tradition,' Dr Brenner explains. The benefits of a daily walk are well established with one 2023 study in GeroScience highlighting its profound impact on cardiovascular health and a reduced risk of hypertension. Meanwhile, 2024 research outlines the benefits of gardening, including improved physical health and related behavioural practices like eating more fruits and vegetables. 6. Forget about material possessions – be content with what you have The residents in Cilento have little need for cars, phones or fancy clothes. 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Beyond lifestyle and diet These daily habits and routines are, of course, only half the picture when it comes to the remarkable health and longevity of Cilento's residents. The researchers are also examining their stem cells, brains, and metabolites, too, through advanced testing run by Professor Catriona Jamieson's team at the Sanford Stem Cell Institute. They hope to discover some of the key biological markers of extreme longevity to aid their development of medical strategies for the treatment of age-related conditions. However, what we can learn from Cilento's residents is that surrounding yourself with friends and family, learning to be content with what you have, and opting for a splash of olive oil every now and again may be the key to living happier, healthier and for longer. The CIAO Study is a multi-institution collaboration that includes Sanford Burnham Prebys, an independent, nonprofit biomedical research institute in San Diego; the Sanford Stem Cell Institute at University of California San Diego; University La Sapienza in Rome and Great Health Science, a network of public and private research organisations based in Rome, Italy. Launched in 2016, the researchers are keen to identify key factors that promote healthy ageing and extreme longevity.
Medical News Today
4 hours ago
- Medical News Today
Insulin resistance test may help predict early Alzheimer's cognitive decline rate
There is currently no tool for predicting how quickly early stage Alzheimer's disease will progress. A new study has identified a simple blood test used to measure insulin resistance that may also help doctors determine which people with early stage Alzheimer's disease are most likely to experience rapid cognitive decline. The test found that higher insulin resistance indicated quicker deterioration in cognitive estimate that about 69 million people around the world are living with prodromal Alzheimer's disease, or early stage Alzheimer's disease. People in the earliest stage of Alzheimer's disease begin to experience some mild cognitive impairment that may affect their memory and ability to complete tasks and communicate. Past studies show that detecting Alzheimer's disease in its earliest stage allows currently available medications and lifestyle changes to be more effective in helping to slow down disease progression. 'Alzheimer's (disease) begins silently, often decades before symptoms appear, and so detecting risk early is essential to slow or alter the disease course,' Bianca Gumina, MD, a neurology resident for the Neurology Unit in the Department of Clinical and Experimental Sciences at the University of Brescia and for the Neurology Unit in the Department of Continuity of Care and Frailty at ASST Spedali Civili Hospital, both in Italy, told Medical News Today. 'Current tools can diagnose the disease, but they don't always predict how fast it will progress. Identifying individuals at higher risk of rapid decline [c]ould allow for timely, targeted interventions during a critical window when the disease could be still responsive to treatment or changes in (lifestyle),' she is part of the research team for a study recently presented at the European Academy of Neurology (EAN) Congress 2025 that has identified a simple blood test used to measure insulin resistance that may also help doctors determine which people with early stage Alzheimer's disease are most likely to experience rapid cognitive decline. The findings of the study are yet to be published in a peer-reviewed TyG Index Test for Alzheimer'sFor this study, researchers analyzed medical records from 315 adults with an average age of about 70 that did not have diabetes. Two hundred of the study participants had received biological confirmation they had Alzheimer's disease. All study participants received insulin resistance assessment using a test called the triglyceride-glucose (TyG) index, with a clinical follow-up three years later. 'The TyG index is a validated marker of insulin resistance, a condition often seen in prediabetes or metabolic syndrome,' Gumina explained. 'It combines triglycerides and fasting blood glucose, two common and non-invasive blood values. (It is) easy to calculate and already available in routine labs.' Higher TyG index results predict quicker cognitive declineAt the study's conclusion, the research team found that when grouping study participants by their TyG index results, those in the highest TyG index group experienced a quicker deterioration in cognitive decline than those with lower TyG index results. 4-fold higher risk'This finding is significant because it highlights a vulnerable window (mild cognitive impairment, the early phase of the disease) when the disease may be especially sensitive to metabolic stress. Patients in this early phase with high TyG levels had a fourfold increased risk of rapid cognitive decline compared to those with lower TyG levels. This suggests that insulin resistance may actively influence how fast Alzheimer's progresses, and identifying this risk early could open new avenues for intervention.'— Bianca Gumina, MD'The TyG index is a low-cost, widely available tool that could be easily integrated into routine clinical practice to flag patients at higher risk of rapid decline,' she continued. 'By identifying these individuals early, clinicians could prioritize them for closer monitoring, lifestyle interventions, or even enrollment in clinical trials, maybe individualizing sub phenotypes of the disease. It also supports the development of metabolic-based treatment strategies, potentially paving the way for therapies targeting insulin resistance to modify disease progression.'As for the next steps in this research, Gumina said the research group is currently exploring whether the TyG index also correlates with neuroimaging biomarkers of brain degeneration. 'The next goal is to integrate metabolic profiling with genetic and imaging data to refine risk models and guide early, personalized interventions,' she added. New potential variable for Alzheimer's progression predictionsMNT spoke with Rehan Aziz, MD, geriatric psychiatrist at Jersey Shore University Medical Center in New Jersey, about this study. Aziz commented that he thought this was a very interesting study involving a new variable to consider when working with patients in the early stages of Alzheimer's dementia, especially as it may predict who is likely to decline faster.'Accurate progression prediction is crucial for multiple reasons,' he explained. 'It empowers families to make informed decisions about care planning, financial arrangements, and how to prioritize quality time together. Clinically, it helps us identify patients who need more intensive monitoring and earlier intervention.''With new disease-modifying treatments like aducanumab and lecanemab becoming available — treatments that carry real risks including brain swelling and bleeding — we urgently need better ways to identify which patients are most likely to benefit from aggressive treatment versus those who might have slower progression,' Aziz continued.'This metabolic marker could help us personalize the risk-benefit calculation for each patient, ensuring we're offering these powerful but potentially risky therapies to those who need them most while protecting slower-progressing patients from unnecessary exposure.'— Rehan Aziz, MDAziz said he'd like to see this study's results validated in larger populations. 'We also need longer follow-up studies to see if this predictive power holds over five to 10 years,' he continued. 'I'm particularly interested in whether interventions targeting insulin resistance — like lifestyle modifications or medications like metformin — could actually slow progression in high-TyG patients. Finally, I'd like to see this integrated with other biomarkers to create a more comprehensive risk stratification tool.' More information on how Alzheimer's progressesMNT also spoke with Peter Gliebus, MD, director of cognitive and behavioral neurology at Marcus Neuroscience Institute, part of Baptist Health South Florida, about this commented that he found the study both fascinating and highly applicable to daily clinical practice. 'As clinicians, we frequently encounter questions from patients and their families, such as, 'How quickly will it worsen?'— and we often don't have a definitive answer,' he explained. 'The prospect that a simple, cost-effective marker like the TyG index could predict progression in Alzheimer's disease is extremely encouraging. It has the potential to bridge an important gap between diagnosis and practical prognosis, which has been a missing element in this field,' he said.'Early-stage Alzheimer's, especially during the mild cognitive impairment stage, exhibits significant variability-some individuals remain stable for years, while others decline rapidly. Identifying those at higher risk of swift decline enables us to customize clinical care and research strategies. It also helps families set clearer expectations and facilitates early, potentially more effective interventions, whether through lifestyle changes, medications or future planning.' — Peter Gliebus, MD'As new treatments are developed, timing and patient stratification will be essential — tools like the TyG index may play a crucial role in that process,' he added.
BBC News
7 hours ago
- BBC News
'Mum's young-onset dementia is 'heartbreaking' says Bristol woman
The daughter of a 58-year-old woman diagnosed with young-onset dementia is sharing her experience to help raise awareness of the Britton, 29, from Bristol, said she knew the symptoms her mum, Maria Britton, was showing in 2023 seemed serious but after initially being put down to the menopause it took months of "pushing" to discover the true Britton, who works as a cabin manager for EasyJet, said in under two years she had gone from being her mum's daughter to her carer which was "heartbreaking".A spokesperson for the Alzheimer's Society said dementia is the leading cause of death in the UK and one in three people will develop dementia in their lifetime. Dementia is most common in people over the age of 65, but about 70,800 people in the UK are living with young-onset dementia, typically diagnosed before the age of 65, according to the Alzheimer's Britton said she wanted to raise awareness as "so many" people talk about cancer, but few realise the likelihood of developing dementia. Less than two years ago, Ms Britton, her mum, and her brother Harry were looking forward to the "holiday of a lifetime" in Disneyland, Florida."My brother had generously paid for my mum, who had always wanted to go, but just before we went things didn't seem right with her," she said."She'd become withdrawn and quiet and went from being so excited, to seeming like she couldn't care less, and lost her normal mannerisms."I was constantly asking her 'are you okay?'. I knew something was wrong, but I didn't know what." 'Really quiet' After they returned home, Ms Britton said her mum, who worked in accounts, admitted she had been making mistakes at work, but she did not know encouraged her to visit a doctor and Maria was told she was experiencing symptoms of the menopause and put on was between September and December 2023, during which time Maria's boss suggested she take time off work to get better."By January she'd become really quiet and distanced herself, like she didn't really want to talk," said Ms Britton."It was really, really strange and not like her, because she was so chatty before, you could never get her to be quiet."Ms Britton pushed for another GP appointment and her mum was referred for a CT scan but no abnormalities were highlighted so she was referred to a brain clinic. Maria resigned from her job, Ms Britton said, adding: "Her speech deteriorated, she would stutter a lot, and she gradually became unable to put sentences together."She was referred to the Dementia Wellbeing Service who visited within the month."That was around the end of August and they did a really thorough investigation, and by this time, mum's speech was worse along with the motor skills of her hands," Ms Britton said."The dementia clinic came back and said mum has a dementia and they believed it to be the behavioural variant - frontotemporal dementia." Having frontotemporal dementia means her mum still knows who everyone is but it has impacted her speech and personality."Mum can only say yes or no now, and her processing's so bad she can't do anything for herself except walk around. In every aspect of her life she needs help," Ms Britton visit three times a day but Ms Britton prepares all her mum's meals, as well as cleaning, shopping and helping her shower. "I change her bedding. I do her laundry. I take care of her finances. I take her to all her appointments. So anything a human needs, especially someone who does have an illness, I do for her." 'Quite scary' Ms Britton said: "At times it is overwhelming and crazy. Twenty months ago she was working, she seemed herself, and now, I'm like her parent, you know the roles are reversed significantly."Now she loves Peppa Pig and Paw Patrol… she loves walking around with her teddy bear."Some days I think – and it sounds selfish – but I just wish I didn't have to be this carer role anymore, because it takes so much away from me and my mum, too."But I never want to see mum sad, so everything I do is for her."Ms Britton and her brother Harry have learned the dementia her mum has is hereditary, so they her are in the process of being referred to a genetics clinic."We can be tested if we want to be. It's quite scary but we're just trying to get on with everything, maintain our lives and be as happy as we can be." Ms Britton wants to raise awareness of the condition and recently joined more than 1,000 people for a 26-mile (41.8km) fundraising walk in the Lake District with her brother Harry and partner than £600,000 was raised for the Alzheimer's Society, with the charity being fundamental to helping her cope, she said."They supported me and my family through the diagnosis and they're there at the end of the phone whenever you need them", she Britton said people do not realise how quickly dementia can deteriorate and advised anyone else going through something similar to "trust your instinct"."I knew immediately on that holiday there was so much more to the quietness and her being withdrawn. I even Googled early-onset dementia when I was away and everyone thought I was being silly."With something like this, the earlier you can - not catch it, because obviously it's not fixable - but the earlier you can recognise signs the easier it is for things to be put in place quicker."
