What's that word? Brain changes begin years before Alzheimer's diagnosis

Researchers now know the brain changes of Alzheimer’s disease (AD) begin years before diagnosis.

Self-reported episodes of confusion may be a predictive indicator of future Alzheimer’s Disease (AD), according to new research from the University of Melbourne.

All methods tested so far to treat AD have failed. Confusion is an important symptom in the elderly that should not be dismissed. It could be a strong indicator of neurodegenerative disease. Therefore, it is crucial to have earlier detection of those at risk without waiting until cognitive decline is obvious.

The University of Melbourne Women’s Healthy Ageing Project (WHAP) is a longitudinal study that has followed women from 45 years of age into their 70s. Most studies in the past have looked at people aged over 60, yet the earliest brain changes can occur in midlife.

Researchers track and measure lifestyle, psychosocial data and neuropsychological levels as well as reported memory complaints and confusion.

Participants had their levels of brain B-amyloid measured because research studies have shown that healthy people with an elevated level of B-amyloid are at risk of cognitive decline.

Professor Cassandra Szoeke, director of the Healthy Ageing Program, Department of Medicine, University of Melbourne, said participants were asked to assess how often they had felt confused and if they felt they had more problems with memory than most.

“We found that participants who self-reported incidents of confusion were more likely to have more B-amyloid protein on their brain scans,” she said.

Co-investigator Dr Georgia McCluskey said the temporal neocortex located in the middle of the brain is usually one of the first sites to show the presence of B-amyloid.

“Two-thirds of those with dementia are women, with a new case of dementia diagnosed every three seconds worldwide,” she said. “Currently time to diagnosis is delayed and patients and carers are calling for earlier diagnosis,” Dr McCluskey said.

Professor Szoeke continued, “In our study, people worried about their memory did not have more clinical or pathological evidence of disease but those with reported confusion did.

“The clinical significance of memory complaints, particularly their indication of subsequent progression to dementia, has been controversial,” she said.

Professor Szoeke said that while studies may show no relationship between reported concerns and memory testing or disease development over several years, it is important to look 10 and 20 years down the track.

“Alzheimer’s Disease is a long game — it doesn’t happen overnight. The good news is, this gives us time to intervene — that’s why it is so important to identify those who should have greater monitoring and risk factor management to delay disease onset,” she said.

Image credit: ©stock.adobe.com/au/jedi-master