Cambridge researchers have demonstrated that it is possible to detect symptoms of brain damage in patients as early as nine years before they are diagnosed with one of a range of dementia-related disorders.

The team examined data from the UK Biobank and discovered impairment in a number of areas, including problem-solving and number recall, across a range of conditions. 

The team examined data from the UK Biobank and discovered impairment in a number of areas, including problem solving and number recall, across a range of conditions. 

The findings of the study were published today in the journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association

The findings suggest that in the future, at-risk individuals may be screened to identify those who would benefit from interventions to lower their risk of getting one of the illnesses, or to identify patients suitable for recruitment to clinical trials for new treatments.

There are currently very few viable treatments for dementia and other neurodegenerative illnesses like Parkinson’s. This is due, in part, to the fact that these illnesses are often recognized only after symptoms appear, but the underlying neurodegeneration may have begun years, if not decades, earlier. This implies that it might already be too late to change the course of the disease by the time people enroll in clinical trials.

Up until now, it hasn’t been clear if changes in brain function could be found before the start of symptoms. Researchers at the University of Cambridge and Cambridge University Hospitals NHS Foundation Trust turned to UK Biobank, a biomedical database and research resource with genetic, lifestyle, and health information from half a million UK participants aged 40–69.

In addition to gathering data on the participants’ health and medical diagnoses, UK Biobank also gathered information on the frequency of falls and the results of a battery of tests that assessed participants’ problem-solving, memory, reaction times, and grip strength. This gave them the opportunity to analyze and determine whether any symptoms existed at baseline, or the time when participant measurements were first taken (between five and nine years prior to diagnosis).

Individuals who later developed Alzheimer’s disease performed worse than healthy controls on tests of problem solving, reaction time, recalling numerical sequences, prospective memory (the capacity to recall future actions), and pair matching. This was also true for individuals who experienced frontotemporal dementia, a more uncommon form of dementia.

Adults who later developed Alzheimer’s were more likely to have fallen within the previous year than healthy adults. Patients who developed a rare neurological disorder called progressive supranuclear palsy (PSP), which affects balance, were more than twice as likely as healthy people to have had a fall.

Patients reported poorer overall health at baseline for every illness evaluated, including Parkinson’s disease and dementia with Lewy bodies.

The study’s first author, a medical student at the University of Cambridge Nol Swaddiwudhipong, said: “When we looked back at patients’ histories, it became clear that they were showing some cognitive impairment several years before their symptoms became obvious enough to prompt a diagnosis. The impairments were often subtle, but across a number of aspects of cognition.

“This is a step towards us being able to screen people who are at greatest risk – for example, people over 50 or those who have high blood pressure or do not do enough exercise – and intervene at an earlier stage to help them reduce their risk.”

Dr. Tim Rittman, a senior author from the University of Cambridge’s Department of Clinical Neurosciences, added: People shouldn’t worry too much if, for instance, they have trouble remembering numbers. Even healthy people occasionally do better or worse than their peers on tests. 

“But we would encourage anyone who has any concerns or notices that their memory or recall is getting worse to speak to their GP.”

Dr. Rittman also said that the results could help find people who could take part in clinical trials for possible new treatments.

“The problem with clinical trials is that by necessity they often recruit patients with a diagnosis, but we know that by this point they are already some way down the road and their condition cannot be stopped. If we can find these individuals early enough, we’ll have a better chance of seeing if the drugs are effective.”

Source: 10.1101/2022.04.05.22273468

Image Credit: Getty

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