Subject: New Study Worth Knowing About: GLP-1s and Alzheimer's
From: Derek from Research Radar <[email-masked]>
To: [email-masked]
Date: Thu, 30 Apr 2026 14:19:32 +0000
List-Id: <derekpruski.substack.com>

View this post on the web at https://derekpruski.substack.com/p/new-study-worth-knowing-about-glp

A new research review just came out in Molecular and Cellular Neuroscience (April 2026) looking at how GLP-1 drugs — the same class as Ozempic, Wegovy, Mounjaro, and Trulicity — might affect Alzheimer’s disease. ScienceAlert covered it, but I wanted to dig into the actual paper and break it down in plain English so anyone in the community can follow along.
Link to the study: https://doi.org/10.1016/j.mcn.2026.104091 [ https://substack.com/redirect/7bf42a5d-3762-4f67-ab19-3d2b2893efef?j=eyJ1IjoiNGl3b2U2In0.sVDxRtmZ85v8kfdamY0krRXGMy3p768BWtuZifRB-Zs ] 
ScienceAlert summary: https://www.sciencealert.com/weight-loss-drugs-may-reduce-buildup-of-alzheimers-proteins-major-review-finds [ https://substack.com/redirect/7afc43b6-816d-46b6-ac3f-b75058899314?j=eyJ1IjoiNGl3b2U2In0.sVDxRtmZ85v8kfdamY0krRXGMy3p768BWtuZifRB-Zs ]
A Quick Primer on Alzheimer’s
Alzheimer’s is defined by two specific things going wrong in the brain:
Amyloid-beta plaques — sticky gunk that builds up between your brain cells. Your body makes a protein called APP and chops it into small pieces. In a healthy brain, those pieces get cleared out. In Alzheimer’s, they clump together into hard plaques that physically block neurons from communicating.
Tau tangles — tau is a protein that lives inside your neurons and acts like the support beams holding the cell’s internal scaffolding together. In Alzheimer’s, tau gets chemically gunked up (a process called “hyperphosphorylation”) and collapses into twisted tangles inside the cell, which then dies.
Plaques outside the cells, tangles inside the cells. Together they’re considered the defining features of Alzheimer’s. Reduce either one, and you’re theoretically slowing the disease.
The reason this matters for the study: GLP-1 drugs appear to reduce both.
What The Researchers Did
A team out of Anglia Ruskin University in the UK did a systematic review — meaning they didn’t run a new experiment, they pulled together every quality study they could find on four specific GLP-1 drugs and looked for patterns:
Liraglutide (Saxenda, Victoza)
Semaglutide (Ozempic, Wegovy)
Exenatide (Byetta, Bydureon)
Dulaglutide (Trulicity)
They searched PubMed, Embase, and Cochrane Library — the three major medical research databases. They ended up with 30 preclinical studies (cells in a dish and animal models) and 2 human clinical trials.
The whole goal: do these drugs actually reduce amyloid plaques and tau tangles? And if so, how?
What They Found in Animal and Cell Studies
This is where the data gets exciting:
22 out of 30 studies showed reductions in amyloid-beta plaques
19 out of 30 studies showed reductions in tau tangles
That’s about 73% showing plaque reduction and 63% showing tangle reduction. In research terms, that’s a strong, consistent signal — not a one-off finding.
By drug:
Liraglutide — the most studied of the four. The most consistent. Reduced both plaques AND tangles across multiple models.
Dulaglutide — fewer studies, but consistent. Reduced both plaques and tangles, and improved cognitive performance in mice.
Semaglutide — mostly positive. Four studies showed reductions, one showed no effect.
Exenatide — most mixed results. Some studies showed reductions, others showed nothing. Smallest overall effect.
How Are GLP-1 Drugs Doing This? (The Mechanisms)
This is the most important section. The researchers identified several pathways through which these drugs appear to fight Alzheimer’s pathology. Walking through them simply:
1. They calm down brain inflammation
Your brain has its own immune cells called microglia. When microglia get stuck in “alarm mode” for too long, they pump out inflammatory chemicals that actually increase the production of amyloid plaques. It’s a vicious cycle — inflammation makes plaques, plaques cause more inflammation.
GLP-1 drugs calm microglia down. Less inflammation means less plaque production at the source.
2. They fix insulin signaling in the brain
There’s a reason researchers sometimes call Alzheimer’s “Type 3 Diabetes.” The Alzheimer’s brain shows insulin resistance — meaning brain cells can’t use sugar for energy properly. That metabolic dysfunction is directly tied to both plaque buildup and tangle formation.
GLP-1 drugs were literally designed to fix insulin signaling. When they restore that function in brain cells, the brain gets better at clearing out toxic protein waste.
3. They turn down the enzymes that make plaques
Remember APP — the protein that gets chopped up into amyloid fragments? The enzymes doing the chopping are called secretases. GLP-1 drugs appear to shift the balance away from the “bad” cutting pattern (which produces toxic plaque material) toward the “safe” cutting pattern (which produces harmless fragments).
In other words, they reduce plaque production at the factory level.
4. They block the enzyme that creates tangles
Tau gets converted into tangles by an enzyme called GSK-3β. GLP-1 drugs activate a signaling pathway (called PI3K/Akt) that inhibits GSK-3β.
Less GSK-3β activity = less tau gunking up = fewer tangles forming inside neurons.
5. They help the brain clean itself out
Your brain has its own waste-clearance system that flushes out toxic proteins. GLP-1 receptors are present on cells called astrocytes that sit around brain blood vessels. When activated, they help move water through the brain in a way that flushes amyloid out.
Imagine cleaning a room — these drugs aren’t just stopping the mess from getting made, they’re also helping take the trash out.
6. They help neurons survive in general
GLP-1 activation increases brain growth factors like BDNF (think of it as fertilizer for neurons), reduces oxidative stress, supports the cell’s energy production, and prevents premature cell death.
This is the big-picture takeaway: these drugs aren’t doing one thing. They’re doing six things at once, all in the same direction. That’s a big deal because most failed Alzheimer’s drugs only targeted one mechanism.
The Human Trial Data — Being Honest Here
This is where I have to slow the hype train down. The two human clinical trials in the review were not nearly as impressive as the animal data:
Liraglutide trial (26 weeks):
No reduction in plaque burden
No improvement in cognition
Did preserve brain glucose metabolism (a sign neurons were still functioning)
Exenatide trial (18 months):
No significant changes in plaques or tangles in cerebrospinal fluid
Did reduce amyloid-beta in extracellular vesicles (an early biomarker)
No cognitive benefit
So: the preclinical data is strong. The human cognitive data is not there yet.
My Analysis — What This Actually Means
A few honest takeaways:
1. Preclinical-to-human translation is the eternal Alzheimer’s problem. The graveyard of Alzheimer’s drug development is full of compounds that worked beautifully in mice and failed in humans. Mouse models are typically genetically engineered to develop pathology fast — which doesn’t fully mirror what happens in a human brain over decades.
2. The lead author’s framing is the right one — prevention, not treatment. The researchers explicitly say these drugs may work as a preventative, not as a treatment for people who already have established cognitive impairment. That tracks with the human trial data — those trials enrolled people who already had Alzheimer’s. By that point, you may simply be too late.
3. The multi-mechanism story is genuinely promising. Past Alzheimer’s drugs failed because they targeted one pathway. GLP-1 drugs hit six at once. That’s a structurally better bet.
4. There’s a confounder nobody can fully solve yet. GLP-1 drugs treat obesity and Type 2 diabetes — two of the biggest modifiable risk factors for dementia. So are these drugs protecting the brain directly, or are they protecting the brain by treating systemic metabolic disease that would otherwise damage the brain? Probably both. The proportions matter for figuring out who actually benefits most.
5. This review only covers the older GLP-1 drugs. Tirzepatide (GLP-1 + GIP) and retatrutide (GLP-1 + GIP + glucagon) aren’t in this analysis. Whether the dual and triple agonists carry a similar — or stronger — neuroprotective signal is still an open question.
6. The peptide research community has parallel tools worth knowing. Compounds like Cerebrolysin, Semax, Selank, and the bioregulators are working on overlapping mechanisms (inflammation, neurotrophic support, neuronal survival) through different pathways. The multi-mechanism neuroprotection theme isn’t unique to GLP-1 drugs — it’s where the entire field is heading.
Bottom Line
This review pulls together strong preclinical evidence that GLP-1 receptor agonists reduce both amyloid plaques and tau tangles through multiple mechanisms — inflammation, insulin signaling, enzyme regulation, brain clearance, and neuroprotection. The signal is consistent and biologically coherent.
Human cognitive data isn’t there yet, but that’s likely because the trials enrolled people too late in the disease. The next wave of trials needs to recruit at-risk people before symptoms start — that’s where the real test happens.
This is one more data point worth tracking as the field develops. Stay measured, watch the next 2-3 years of trial readouts, and don’t get ahead of the evidence.
Drop questions or thoughts below.
Disclaimer: This content is for research and educational purposes only and is not medical advice. All compounds discussed (peptides, GLP-1 receptor agonists, and related research chemicals) are referenced in the context of research use only (RUO) and the published scientific literature. Nothing in this post should be interpreted as a recommendation for human consumption, diagnosis, prevention, or treatment of any disease or condition. Always consult a qualified healthcare professional for medical decisions.

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