A major randomized trial from Novo Nordisk found that semaglutide did not slow cognitive decline in early Alzheimer’s disease, contradicting earlier observational studies that hinted at potential benefit. The result underscores that medication-driven metabolic improvements alone may be insufficient once neurodegeneration is underway.

Alzheimer’s is marked by the brain’s reduced ability to use glucose for energy, even decades before symptoms appear. Yet the brain can still use ketones efficiently. Early research on ketogenic diets and therapeutic ketosis shows improvements in brain energy, cognition, and daily functioning, suggesting that providing an alternative fuel source may address a key deficit drugs haven’t solved.

While GLP-1 medications remain useful for metabolic disease, their failure in Alzheimer’s highlights the need to invest in nutritional and metabolic therapies, which may offer meaningful benefits despite limited funding and lack of pharmaceutical backing.

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