A recent meta-analysis of trials that included people with AD or mild cognitive impairment showed a benefit of 20 IU/day, with a trend for 40 IU/day, of intranasal insulin with respect to one outcome measure, the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), but not on several other cognitive measures [61]. This evidence concerns the gene INS and early-onset autosomal dominant Alzheimer disease.