However, a 12-month, randomized, double-blind, multicenter study which compared MK-677 with placebo in patients (n = 563) with mild to moderate AD found no significant difference between groups on measures of cognition and activities of daily living (ADL).[73] Perhaps treatments such as this need to be tested earlier during the course of the disease; once the Alzheimer pathology is established, induction of IGF-1 may serve little purpose. This evidence concerns the gene IGF1 and Alzheimer disease.