A survey of more than 100 studies involving PIB-PET, a diagnostic tool that involves injecting a radiotracer called Pittsburgh compound B into the brain via the bloodstream, and imaging the brain with positron emission tomography (PET), has confirmed its sensitivity in detecting amyloid-beta protein plaques. The tool is not yet commercially available. The study also provides strong evidence supporting the theory that accumulation of amyloid-beta protein plaques in the brain is central to the development of Alzheimer’s. The findings, that amyloid deposits appear to reach a plateau early in the disease course, may explain why Alzheimer's patients have not responded to promising experimental drugs that target amyloid. It may be that they are being administered too late.
Review confirms early diagnosis tool
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Default mode network changes predict Alzheimer’s
Data from 848 adults of all ages has found that brain volume in the default mode network declined in both healthy and pathological aging, but the greatest decline occurred in Alzheimer’s patients and in those who progressed from mild cognitive impairment to Alzheimer’s disease. Reduced brain volumes in these regions were associated with declines in cognitive ability, the presence of Alzheimer’s biomarkers in the cerebrospinal fluid, and with carrying the “Alzheimer’s gene”, the APOE4 allele.
Memory complaints linked to higher risk of MCI & dementia
Data from 6257 older adults (aged 55-90) evaluated from 2005-2012 has revealed that concerns about memory should be taken seriously, with subjective complaints associated with a doubled risk of developing mild cognitive impairment or dementia, and subjective complaints supported by a loved one being associated with a fourfold risk. Complaints by a loved one alone were also associated with a doubled risk. Among those with MCI, subjective complaints supported by a loved one were associated with a threefold risk of converting to dementia.
Smell tests provide early evidence of dementia
In the past few months, several studies have come out showing the value of three different tests of people's sense of smell for improving the accuracy of MCI and Alzheimer's diagnosis, or pointing to increased risk. The studies also add to growing evidence that a decline in sense of smell is an early marker for mild cognitive impairment and Alzheimer’s. Indeed, it appears that this sensory loss is a very early symptom, preceding even the shrinking of the entorhinal cortex (the first brain region to show signs of atrophy).
Down Syndrome risk of Alzheimer’s connected to white matter integrity
Brain scans of 10 persons with Down syndrome but no dementia, 10 persons with Down syndrome and dementia, and 10 healthy controls, have revealed a linear correlation between cognitive ability and compromised white matter connections in the frontal lobes among those with Down syndrome. Those with higher cognitive ability and motor skill coordination had healthier white matter integrity, and those with additional dementia showed the most deterioration.
Adults with Down Syndrome are known to be at high risk of developing Alzheimer’s after age 40.
‘Lopsided’ test scores may predict Alzheimer’s sooner
Cognitive testing for dementia has a problem in that low scores on some tests may simply reflect a person's weakness in some cognitive areas, or the presence of a relatively benign form of mild cognitive impairment (one that is not going to progress to dementia). A 2008 study found that one of every six healthy adults scored poorly on two or more of 10 tests in a brief cognitive battery. Following this up, the same researchers now show that a more holistic view might separate those who are on the path to dementia from those who are not.
New biomarkers for early Alzheimer's diagnosis
Analysis of 40 spinal marrow samples, 20 of which belonged to Alzheimer’s patients, has identified six proteins in spinal fluid that can be used as markers for Alzheimer's. The analysis focused on 35 proteins that are associated with the lysosomal network — involved in cleaning and recycling beta amyloid. None of the six proteins had previously been linked to Alzheimer’s.
http://www.eurekalert.org/pub_releases/2013-10/lu-ast102313.php
Early detection and treatment of Alzheimer's makes a difference
A Finnish project (ALSOVA) has been following 240 patient-caregiver pairs, where the patient had very mild or mild Alzheimer's disease at the beginning of the study and had a family caregiver. A three-year follow-up of 115 patients has found that those diagnosed and treated very early were able to manage their everyday activities longer and suffered from less psychological and behavioral symptoms, compared to those diagnosed later.
Brain changes linked with Alzheimer's years before symptoms appear
A very long-running study involving 290 people at risk of Alzheimer's has found that, in those 81 people who developed MCI or dementia, subtle changes in cognitive test scores were evident 11 to 15 years before the onset of clear cognitive impairment. They also showed increases in the rate of change of tau protein in cerebrospinal fluid an average of 34.4 years (for t-tau, or total Tau) and 13 years (for a modified version called p-tau) before the beginning of cognitive impairment.
Atypical form of Alzheimer's disease more common than thought
Analysis of 1,821 Alzheimer’s brains has found that 11% of them actually suffered from a variant called hippocampal sparing Alzheimer’s. This subtype has been neither well recognized nor treated appropriately, but is now revealed to be relatively common.
Tau-amyloid ratio predicts MCI
Initial findings from an analysis of cerebrospinal fluid taken between 1995 and 2005 from 265 middle-aged healthy volunteers, of whom 75% had a close family member with Alzheimer’s disease, has found that the ratios of phosphorylated tau and amyloid-beta could predict mild cognitive impairment more than five years before symptom onset — the more tau and less amyloid-beta, the more likely MCI will develop. The rate of change in the ratio over time was also predictive — the more rapidly the ratio of tau to amyloid-beta went up, the more likely the eventual development of MCI.
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