The hunt for new and earlier ways to track down Alzheimer’s disease continues. Scientists look for clues in your eyes, your speech even the way you smell as they try to uncover possible ways to mark early warning signs of the disease, the most common form of dementia.
There is no cure for this debilitating and life-changing disease that undermines a person’s memory, thinking and behavior.
But scientists believe if they can figure out how to label it sooner, they may use medications, lifestyle changes, or other strategies to fight it before it causes irreversible brain damage.
More than 5 million Americans have Alzheimer’s disease, and the Alzheimer’s Association says the number could be as high as 16 million by 2050. That is, every 66 seconds, someone in the U.S. develops the disease.
There isn’t a single test to diagnose Alzheimer’s. But changes in the brain related to the disease can be years before any signs of its onset, and there is now a focus on looking for these early warning signs.
Look out for Alzheimer’s warning signs.
Doctors at Cedars-Sinai Medical Center in Los Angeles developed the first eye test for Alzheimer’s disease.
The researchers say results of a study in the U.S. and Australia show that technology that uses light to look into the eye may be key to detecting the debilitating disease 15 to 20 years before doctors can diagnose it now.
“The back of the eye, the retina, is an extension of the brain. The key observation from our group was that the hallmark of Alzheimer’s disease – amyloid plaque – is one of the first signs to develop in Alzheimer’s disease, and it occurs not only in the brain but also in the retina “, explains Keith L. Black, MD, chairman of the Cedar Sinai Department of Neurosurgery.
Black says the test takes about 20 minutes. It is non-invasive, affordable, and has been very precise in determining when someone does not have the disease and has a good track record for telling patients when they have it.
As part of the study, the researchers are now tracking the progress of the plaques in some patients. The test is being used in clinical trials in hospitals in the U.S. and Australia but is unavailable to the general public.
Sense of direction
A study published in August 2017 says the loss of navigational ability could be another early sign of Alzheimer’s.
Researchers showed patients a path and asked them to reproduce it while remembering curves and locations in the study.
These assessments included real navigation tasks on the street or in hospital corridors and also virtual environments computer mock-ups of real environments, “says Dr. Scott Moffat, who co-authored the paper.
He is an adjunct professor in Atlanta’s Georgia Institute of Technology School of Psychology.
In Alzheimer’s disease, “wandering” or “getting lost” is a common trait and complaints from patients and caregivers, “he says. “One reason we think who may impair navigation early in aging and dementia is that we can observe them in behavior.”
Moffat says there is a second reason as well.
We believe that navigation assessment could be a good early marker of Alzheimer’s disease in the future because it depends on the same brain systems that are most affected in Alzheimer’s disease, “he explains.
He says who could also use the navigation to test how well drugs and behavioral therapies are working.
The disadvantages of navigational assessment, researchers say, are a lack of a standard test to find out how well someone can navigate and that those skills vary a lot between people.
From smelling … to language
Testing your sense of smell by identifying and naming smells could also be an early warning sign of Alzheimer’s disease.
Researchers at McGill University in Montreal tested older people who were thought to be more likely to get Alzheimer’s disease because a parent or several siblings had been diagnosed with it.
With the help of a scratch-and-sniff booklet, they linked odor determination with Alzheimer’s-specific proteins in the brain and spinal cord.
The research found that a decreased ability to identify scents was associated with lower thinking and memory skills, older age, and brain shrinkage.
Researcher Marie-Elyse Lafaille-Magnan, a graduate student involved in the study, says odor identification is helpful because it involves many parts of the brain.
In other studies, the Alzheimer’s Association gives promising evidence of possible precursors of Alzheimer’s disease, including:
Hearing loss could show that older adults have deteriorated thinking skills, including new information processing, flexible thinking, and the coordination of the brain, eye, and hand when processing information.
Another study showed that changes in everyday language – including the use of short sentences, more pronouns, and pauses like “um” and “ah” – were linked to mild early-stage intellectual impairment that may be a precursor to Alzheimer’s disease.
And another study found that older adults are at high risk for memory and thinking problems after being hospitalized for emergency or urgent admissions, but not for choice or scheduled surgeries.
Value in early detection
There isn’t a cure for Alzheimer’s disease, so what’s the value of knowing you could get the disease – years before you did?
For researchers, it’s about prevention.
The better we understand the sequence of changes over time and recognize biomarkers, which are early markers for brain changes, the better we can use them in prevention studies, “explains Lafaille-Magnan.
The Alzheimer’s Association says early detection gives people better chances of getting treatment, more time to plan for the future, more opportunities to participate in clinical trials, and the opportunity to make decisions about care, housing, and financial and legal issues.
Black says Alzheimer’s disease develops about 20 years before you lose memory and think and have behavior problems. So by the time you show symptoms, you’ve already lost brain cells and brain connections.
If you could intervene sooner before you lost those brain cells, you might even get a better therapeutic outcome, “he says.
But Jeffrey Sherman, MD, a family doctor in Washington, D.C., says that testing for early signs of Alzheimer’s could be complicated in the real world.
“It’s complex,” he says. Would knowing about an increased risk change what you want to achieve in the next 5 years of your life?
They are not guaranteed to develop, but if they did, would they change their family situation, or how do they organize their finances or general plans differently? If so, then we could take a look.”
Sherman says he enjoys talking to patients about getting the most out of their mental abilities.
Stressing there are no guarantees, he says, that he will be actively talking about the benefits of exercising and keeping the mind active using crossword puzzles, sudoku games, bridge, or work.
Researchers in the navigational skills study recommend that people not always rely on GPS systems to get them where they need to go but instead use their navigational skills to train that part of their brain.
Black agrees that lifestyle habits can play an important role in the progression of the disease.
When a patient knows that they are on their way to developing Alzheimer’s, we know that they are changing their diet to a Mediterranean diet, exercising, relieving stress, getting 8 hours of sleep a night.
All of these things are now showing in more and more scientific studies suggest that they can play a very important role in slowing the progression of the disease into the symptomatic phase, “he says.
Micronutrients like curcumin, omega-3 fatty acids, and flavonoids could also help.
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