Unmasking Dementia Signs 9 Years Before Diagnosis

Do dementia signs show up before diagnosis? It is possible to see signs of dementia as early as nine years before a person receives a diagnosis.

Highlights:

More than 55 million people globally have dementia but there was no way to do a prior prediction
Now, researchers show it is possible to detect signs of dementia nine years before diagnosis
People with dementia were more likely to have had a fall and poorer overall health compared to others

Signs of brain impairment can be seen in patients as early as nine years before they actually receive a diagnosis for one of several dementia-related diseases, according to research published in Alzheimer's & Dementia.

This finding is obtained after analyzing data from the UK Biobank and finding impairment in several areas, such as problem-solving and number recall, across a range of conditions.

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‘Dementia can be predicted 9 years before actual diagnosis in people who have a fall and poorer overall health compared to others.’

What is Dementia?

Dementia is an umbrella term that comprises conditions impacting the brain, making it difficult to remember things, communicate, or accomplish everyday tasks like driving or using a cell phone. Most people begin to show signs of dementia in their mid-60s; however, some can begin as early as their 30s ().

There are currently very few effective treatments for dementia or other neurodegenerative diseases such as Parkinson’s disease. In part, this is because these conditions are often only diagnosed once symptoms appear, whereas the underlying neurodegeneration may have begun years – even decades – earlier.

This means that by the time patients take part in clinical trials, it may already be too late in the disease process to alter its course. Until now, it has been unclear whether it might be possible to detect changes in brain function before the onset of symptoms.

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Are Signs of Dementia Seen Much Before Diagnosis

To help answer this question, researchers at the University of Cambridge and Cambridge University Hospitals NHS Foundation Trust turned to UK Biobank, a biomedical database and research resource containing anonymized genetic, lifestyle, and health information from half a million UK participants aged 40-69.

Apart from collecting information on participants’ health and disease diagnoses, UK Biobank collected data from a battery of tests including problem-solving, memory, reaction times, and grip strength, as well as data on weight loss and gain and the number of falls. This allowed them to look back to see whether any signs were present at baseline – that is when measurements were first collected from participants (between five and nine years before diagnosis).

People who went on to develop Alzheimer’s disease scored more poorly compared to healthy individuals when it came to problem-solving tasks, reaction times, remembering lists of numbers, prospective memory (our ability to remember to do something later on), and pair matching. This was also the case for people who developed a rarer form of dementia known as frontotemporal dementia ().

People who went on to develop Alzheimer’s were more likely than healthy adults to have had a fall in the previous 12 months. Those patients who went on to develop a rare neurological condition known as progressive supranuclear palsy (PSP), which affects balance, were more than twice as likely as healthy individuals to have had a fall.

For every condition studied, including Parkinson’s disease and dementia with Lewy bodies – patients reported poorer overall health at baseline.

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Identifying Patients at High Risk for Dementia

Looking 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 several aspects of cognition.

These findings raise the possibility that in the future, at-risk patients could be screened to help select those who would benefit from interventions to reduce their risk of developing one of the conditions or to help identify patients suitable for recruitment to clinical trials for new treatments.

These findings could also help identify people who can participate in clinical trials for potential new treatments.

References:

Alzheimer's Disease and Healthy Aging - (https://www.cdc.gov/aging/dementia/index.html)
Pre-diagnostic cognitive and functional impairment in multiple sporadic neurodegenerative diseases - (https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12802)

Source-Medindia

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