The Latest News on Alzheimer's Disease   | Memory Test

Signs of Alzheimer's Found Ten Years Early

by Kathleen Fackelman, USA Today

The first hints of impending Alzheimer's include not just forgetfulness but lags in attention and other subtle problems that can show up 10 years before an official diagnosis, a study out Monday says.

The new report underscores the scientific view that Alzheimer's begins to injure the brain years before the hallmark symptoms of severe memory loss appear, says William Thies, spokesman for the Chicago-based Alzheimer's Association. Very early identification of Alzheimer's could become even more important in the future if researchers develop therapies that delay this degenerative brain disease, he says.

Such therapy is urgently needed: The population of Alzheimer's victims is expected to rise from 4.5 million to as many as 16 million people by the year 2050.

  Alzheimer's warning signs

Lars Bäckman of the Karolinska Institute in Stockholm and his colleagues grouped together the findings from 47 scientific studies. They found a pattern of subtle thinking deficits that seemed more common in people destined to get Alzheimer's. The team homed in on 1,207 older people who had been given cognitive tests years before getting a diagnosis. They compared them with 9,097 older people who had been given the same tests but who stayed healthy.

The team's meta-analysis, a powerful statistical method that culls results from many studies, revealed that the people who would later develop Alzheimer's showed small deficits in memory, a finding that fits with what is known about the way Alzheimer's affects the brain.

Full-blown Alzheimer's attacks the hippocampus, the brain's memory region, Bäckman says. But at very early stages, the disease has yet to produce serious damage: Thus forgetfulness is minor, he says. For example, people might have trouble remembering what they had for breakfast but can still keep track of important appointments.

The team also found a raft of other difficulties, a finding that suggests the disease attacks other brain regions as well. For example, people destined to get Alzheimer's scored poorly on tests of executive function, the ability to plan ahead or multitask.

The people who ended up with Alzheimer's also took longer to solve problems and did a little worse on tests of verbal ability, Bäckman and his colleagues report in the July Neuropsychology.

But the slight deficits in memory and speed could easily be written off as an age-related decline, Bäckman says. Old age itself can produce minor lapses in memory and a slowdown in mental agility, he says.

Researchers have yet to develop a test that reliably identifies people who will develop Alzheimer's in the future, says Ronald Petersen, an Alzheimer's expert at the Mayo Clinic in Rochester, Minn.

Drugs available now do not slow the disease, so there is no rush to find people at this preclinical stage. But that may change if therapies in the pipeline pan out, Petersen says. Then an early diagnosis combined with treatment could stop the disease before a great deal of damage occurs.

"We want to give people lots of time to aggressively treat this disease that makes your brain rot," Bäckman says.

More information

Alzheimer's

Is there any treatment?

There is no cure for AD and no way to slow the progression of the disease. For some people in the early or middle stages of AD, medication such as tacrine (Cognex) may alleviate some cognitive symptoms. Donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl) may keep some symptoms from becoming worse for a limited time. A fifth drug, memantine (Namenda), was recently approved for use in the United States. Combining memantine with other AD drugs may be more effective than any single therapy. One controlled clinical trial found that patients receiving donepezil plus memantine had better cognition and other functions than patients receiving donepezil alone. Also, other medications may help control behavioral symptoms such as sleeplessness, agitation, wandering, anxiety, and depression. Prevention, through lifestyle changes and mental and physcial exercise, represents one of the best ways to reduce the likelihood of getting the disease, coupled with regular, systematic monitoring.  

What is the prognosis?

AD is a progressive disease, but its course can vary from 5 to 20 years. The most common cause of death in AD patients is infection.  As the population ages and other diseases are brought under control - Alzheimer's becomes a major risk.

What research is being done?


Scientists are currently studying or testing different types of drugs and other substances to determine if they can stop AD progression, including nonsteroidal anti-inflammatory drugs (NSAIDS), statins (such as those used for lowering cholesterol), folic acid, gingko biloba, huperzine, and vitamins E, B6, and B12. Studies in basic science are also exploring the potential of vaccines. Regular  'screenings' are being advocated by some - with the U.S. House of Representatives recently passing a bill in support of early memory check-ups.  All advocate a regimen of physical exercise and mental exercise. If you start an exercise regimen or just walking use MemCheck to track your progress.

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Source: NIH and Cognitive Advisors. For a qualified medical opinion or diagnosis, please see your healthcare provider.  

Famous People and Alzheimers: former President Ronald Reagan, Grambling University football coach Eddie Robinson, actor Charlton Heston, actor James Doohan.   
                                                                                   
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