Alzheimer’s disease is stealing the memories of millions of people, and currently there’s no way to detect the disease before a significant amount of brain damage has occurred. However, researchers are seeking ways to predict dementia in people who may be in the early stages of Alzheimer’s disease but are years away from exhibiting its telltale symptoms.
“We’re beginning to develop predictive testing in healthy older people to see who is at very high risk,” says Dr. John Morris, director of the Alzheimer’s Disease Research Center at Washington University. One of the field’s top researchers, Morris has been studying Alzheimer’s disease for more than two decades. He says he’s optimistic that scientists are getting closer to the breakthroughs that will allow for broad testing and early treatment that may arrest or halt disease progression.
Early detection of the neural plaques and tangles that mark the brains of Alzheimer’s patients is possible, but the techniques are still experimental and probably several years away from widespread use, Morris says.
For nearly 10 years, scientists have been identifying certain proteins associated with the formation of plaques in the brain. These plaques have been linked to the presence of the protein beta amyloid, which appears to influence the development of Alzheimer’s disease. Thus, identifying beta amyloid in cerebrospinal fluid, via a spinal tap, “looks to be highly predictive,” Morris says.
“In the past five years, we’ve discovered a new technique that allows amyloid plaques to be imaged using PET scans,” he says. In 2004, University of Pittsburgh researchers developed an amyloid tracer compound that can bind to plaques and give off a radio signal, which PET scanning can detect. “This has revolutionized how we think about imaging amyloid,” Morris says. While only a few laboratories in the country currently produce the compound used in the imaging tests, “the race is on to develop cousins of the compound that could be used more broadly.”
In December, Morris and his research team published a paper in Archives of Neurology showing that healthy older adults who are imaged and found to have amyloid in their brains are at high risk of developing dementia. The team plans to replicate the small study with a larger group of subjects to confirm the findings.
Until scientists make more progress in the field of Alzheimer’s testing, there is very little anyone can do to slow the disease. Current drug therapies are only marginally helpful by the time a patient is diagnosed, which makes early detection even more critical, says Dr. Abhilash Desai, director of the Center for Healthy Brain Aging at Saint Louis University.
“If we could start administering existing drugs five or 10 years before the patient would normally become symptomatic, perhaps they would be more effective,” he says. Also, new types of medications may be developed to head off dementia in those found to be at high risk.
Although Alzheimer’s disease continues to be a terrible diagnosis, Desai urges people to focus on the things they can do to prevent or manage the disease. First, he recommends complete neuropsychological testing with a qualified specialist if you or someone you know is exhibiting signs of dementia. The testing identifies specific functional difficulties in a variety of cognitive and behavioral areas.
If Alzheimer’s disease is suspected, lifestyle changes may be a major part of the treatment plan. “The brain has a tremendous capacity to get better,” Desai says. “We believe that exercise, nutrition, stress management and healthy habits can help postpone dementia.”
Desai’s prescription for a lifestyle that promotes a healthy brain includes regular cardiovascular exercise; a healthy diet rich in fruits and vegetables that limits saturated fats; stress management through yoga, meditation or counseling; enjoyable, stimulating, challenging mental activities; and regular social interaction.
“There’s very promising research underway, but lifestyle will always be important for healthy aging,” he concludes.