Alzheimer's Club

"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

• Serious memory loss. People with Alzheimer's frequently forget appointments, telephone numbers and important information.
• Difficulty performing everyday tasks. They might not remember how to complete a familiar routine.
• Problems with abstract thinking. Those with Alzheimer's can't do simple math; they might forget what the numbers represent.
• Confusion. They can get lost coming home from a familiar place.
  Source: William Thies of the Alzheimer's Association. For more information, call 800-272-3900.

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."

Source: Kathleen Fackelmann. Signs found 10 years in advance of Alzheimer's. USA Today (31 July 2005) [FullText]