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Observational evidence further supports a context-dependent effect of metformin, as data from the National Alzheimers Coordinating Center database found that metformin use was associated with improved memory performance, but this benefit was not observed in APOE-4 carriers 90 , suggesting that metformin may be protective in individuals with DM2 but not in those with certain genetic predisposition factors for AD, such as APOE-4, which is the strongest genetic risk factor for sporadic AD 91

But the gap between the two compounds may narrow in real-world settings where adherence and dose optimization are less consistent

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For many, managing Type 2 diabetes begins with metformin, though its often insufficient alone

Prophylactic effects of quercetin and hyperoside in a calcium oxalate stone forming rat model