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Alzheimer’s disease, which is the most common type of dementia, is on the rise. About 57 million people had dementia worldwide in 2021, and the numbers are escalating. This progressive neurodegenerative disorder affects the quality of life, even impacting daily activities, and hence, early diagnosis is crucial. Researchers have now found that a simple blood test may soon help doctors predict which patients with early Alzheimer’s disease are most at risk of rapid cognitive decline. They also found that a common condition related to metabolic disorders could dramatically accelerate the disease.

The research was led by neurologists at the University of Brescia in Italy and was presented at the European Academy of Neurology (EAN) Congress 2025.

Common condition linked to accelerated Alzheimer’s disease

The common condition in question is . The researchers looked at the records of 315 non-diabetic patients with cognitive deficits, including 200 with biologically confirmed Alzheimer’s disease. All participants underwent a TyG index assessment and were followed clinically over three years.

The researchers found that the patients in the highest third of the TyG index within the Mild Cognitive Impairment-AD subgroup declined significantly faster than those with lower readings, losing more than 2.5 points per year on the widely used Mini-Mental State Examination. The ratio for rapid progression was 4.08 (95% CI 1.06–15.73), which is a fourfold increase in risk.

“Once mild cognitive impairment is diagnosed, families always ask how fast it will progress. Our data show that a simple metabolic marker available in every hospital laboratory can help identify more vulnerable subjects who may be suitable candidates for targeted therapy or specific intervention strategies,” lead investigator Dr Bianca Gumina said in a statement.

Impact of insulin resistance on Alzheimer’s disease

Though previous research has shown the association between insulin resistance and , its role in how quickly the condition progresses has not been much explored. This recent study looked into insulin resistance’s impact during the prodromal mild cognitive impairment (MCI) stage, when patients follow highly variable trajectories.

What is insulin resistance

Insulin resistance is a condition where the body's cells do not respond properly to insulin. Insulin is a hormone produced by the pancreas that helps glucose (sugar) enter cells for energy. To compensate, the pancreas produces more insulin, but over time, this can lead to elevated blood sugar levels (hyperglycemia), increasing the risk of type 2 diabetes and other serious health conditions.

The study

The researchers used the TyG index, a simple and affordable way to measure insulin resistance, to see if metabolic problems could help predict how quickly cognitive decline happens after diagnosis.

“We were surprised to see the effect only in the Alzheimer’s spectrum and not in other neurodegenerative diseases. It suggests a disease-specific vulnerability to metabolic stress during the prodromal window, when interventions may still change the trajectory”, Dr Gumina added.