Areas or patterns of reduced glucose metabolism are often seen in brain scans of patients with Alzheimer disease and other dementias. Now, a growing body of evidence suggests that glucose hypometabolism may be more than just a biomarker on brain scans: it may be a key player in dementia pathology.

At the Society for Neuroscience’s recent annual meeting, several research teams presented data on mechanisms that may hamper brain energy metabolism in Alzheimer disease—and potentially contribute to cognitive decline. At the same time, clinical researchers are exploring ways to slow or prevent dementia using drugs and lifestyle modifications typically prescribed for metabolic disorders like diabetes or obesity. These lines of inquiry have taken on new urgency as several amyloid-targeting therapies for Alzheimer disease have failed in clinical trials, leading to questions about whether the so-called amyloid hypothesis may be flawed.