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Insulin nasal spray improved cognition in adults with Alzheimer's disease

A higher dose of intranasal insulin detemir improved cognition among patients with Alzheimer’s disease and mild cognitive impairment, with greater improvement among carriers of the APOE-e4 gene, according to pilot study data.

“The study provides preliminary evidence that insulin detemir can provide effective treatment for people diagnosed with mild cognitive impairment [MCI] and Alzheimer’s-related dementia similar to our previous work with regular insulin,” Suzanne Craft, PhD, professor of gerontology and geriatric medicine at Wake Forest School of Medicine, Winston-Salem, NC, said in a press release. “We are also especially encouraged that we were able to improve memory for adults with MCI who have the APOE-e4 gene, as these patients are notoriously resistant to other therapies and interventions.”

Suzanne Craft

Craft and colleagues examined 60 adults diagnosed with MCI or mild-to-moderate Alzheimer’s disease. They were administered intranasal placebo (n=20), 20 IU of insulin detemir (n=21), or 40 IU of insulin detemir (n=19) for 21 days.

They found that treatment with 40 IU intranasal detemir was associated with improved verbal memory for adults with MCI and Alzheimer’s disease who were APOE-e4 carriers compared with placebo, according to data.

These data indicated that the effect was moderated by patients’ APOE status (P<.05); patients with the APOE-e4 gene showed greater improvement in cognition (P<.02) than noncarriers (P<.02).

Greater insulin resistance at baseline predicted better outcomes with the 40 IU dosages (P<.02).

Those who received the higher dose demonstrated significant improvements in verbal working memory (P<.03) and visuospatial working memory (P<.04), according to data.

“Alzheimer’s is a devastating illness, for which even small therapeutic gains have the potential to improve quality of life and significantly reduce the overall burden for patients, families and society,” Craft said in the release. “Future studies are warranted to examine the safety and efficacy of this promising treatment.”

Disclosure: This study was supported by National Institute of Aging grants and the Department of Veterans Affairs.