How to spot Alzheimer's in time

Posted on: 25 July 2011 by Gareth Hargreaves

Detection is getting easier, but effective treatment remains elusive

Alzheimer's Disease

Last week the Alzheimer's Association International Conference (AAIC) took place in Paris. Apart from findings that claim lifestyle has a major role to play in causing the illness, Alzheimer's remains both ruinous and hard to treat. However, as The Telegraph reports, a new test developed in Australia and also announced at the conference may be able to detect it long before symptoms appear:

...The blood test, developed at Australia's national science agency, CSIRO, is the first to demonstrate a good level of accuracy when compared against brain scans and other established methods of testing for the disease.

Brain scans can be used to detect the sticky protein, known as beta amyloid, but are too expensive and impractical to be used for routine screening...

...The blood tests were able to identify 83 per cent of people whose brain scans revealed high amyloid levels, and to rule out 85 per cent of people who did not have the condition...

That does, however, leave 17% of cases potentially undetected and 15% of people still wondering if they've got the disease or not. Given how computers and mobile telephones have developed, growing both smaller and cheaper and ever more available, then surely small, portable CATscans aren't beyond the realms of possibility? If nothing else, being able to show everyone what your cereberal cortex looks like will break the ice at parties.

The other caveat, according to Bloomberg, is that the assumptions behind the experiment are quite specific too. As in, they're based on the average amount of time it takes for Alzheimer's to develop (which means the test won't always spot it quickly enough) and the number of test subjects is still quite low:

...They started with blood samples from 273 study participants and identified nine hormones and proteins that seemed most predictive of amyloid levels in the brain. A cutoff level was set for what was considered high.

"The belief is that people above that point will go on to get Alzheimer's disease, and the lag is about 8 to 10 years," Burnham explained...

Further research has involved 891 more people, from Australia and the US, but it's admitted that more work needs to be done, with a wider range of test subjects, and more factoring in of how quickly Alzheimer's can sometimes develop.

Nonetheless, there is a possibility that early detection of Alzheimer's will allow much more effective treatment. Another team of researchers at the conference, based in Washington University, have studied families with the condition and hope to use this as another means of early detection, as the LA Times notes:

..Patients with a certain mutated gene will always inherit Alzheimer's, with symptoms beginning in the 50s, 40s or even sometimes the 30s. The researchers can thus study families in which parents pass the gene on to their offspring to look for very early signs of the disease. The disorder is very rare, however, accounting for only about 1% of Alzheimer's cases, so researchers at many institutions in the DIAN group must pool their resources. The researchers have now enrolled 184 family members, including some with the mutation and others without it. They hope eventually to enroll 400...

Despite the rareity of the gene that gets passed on, making this kind of Alzheimer's quite unusual, the ability to predict its presence decades before it takes effect is remarkable:

...At times up to 30 years before the expected onset of symptoms, children with the mutated gene have unusually high levels of beta-amyloid and lower-than-normal levels of tau protein. About 10 years before symptoms develop, those situations reverse, and CSF levels of the proteins become more characteristic of patients with Alzheimer's...

Time may be the best weapon against Alzheimer's:

...The team is now making plans to test new drugs in the family members. There are, effectively, no drugs that have proved useful in slowing the progression of Alzheimer's. Some scientists believe that is because the disease has progressed so far when treatment is begun that the drugs have no value. If patients could be treated at an earlier stage, the drugs might work better. The team already has 11 candidates that might undergo testing...

But here we hit a snag. If early treatment doesn't help, then the lack of treatment for Alzheimer's will continue to be a major problem. Not coincidentally, the condition only receives 8% of the funding in the UK that cancer research does. While promising, then, these findings may only be small steps to a much larger solution.

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