LESIONS characteristic of Alzheimer’s disease have been found in the brains of healthy people in their 40s – and a simple mental skills test may be able to detect the problem many years sooner than previously thought.
Alzheimer’s disease and other forms of dementia are diagnosed only when symptoms appear, which almost always means when patients are in their 70s or 80s.
To date, there has been no reliable way of telling whether someone younger will develop dementia, and little research on people aged under 50.
But Australian and British researchers who studied a group of 431 healthy Canberrans aged from 44 to 48 have found those who performed less well on a specific cognitive test were much more likely to have the lesions in the brain’s white matter.
The lesions in the middle-aged group, picked up on magnetic resonance imaging scans, were tiny, and none of the group had any symptoms of dementia.
Alzheimer's
The team believes the tests could mean patients with Alzheimer’s are discovered early and offered treatment.
Professor David Bunce, a psychologist working at the Australian National University, who led the study, said: “Although we cannot be certain these middle-aged people will go on to get dementia, the results are important.”
The study, published in the respected journal PLoS One, involved 428 volunteers aged between 44 and 48.
The memory test required them to recall 16 shopping items more than 20 minutes after being shown the shopping list.
Volunteers were also asked to memorise 12 faces from photographs they were shown for only 45 seconds as well as taking part in a word game.
Alzheimer's
The results showed that patients with lesions in the brain were more likely to struggle with certain memory skills.
Rebecca Wood, chief executive of the Alzheimer’s Research Trust, said: “Long-term, large-scale trials are needed to test this theory.”
Meanwhile, a study has found indulging in fatty foods during middle age may not increase the risk of dementia.
The study’s lead author Michelle Mielke, of John Hopkins University School of Medicine in the US, said: “Our research refutes the notion that high cholesterol in mid-life is a risk factor for Alzheimer’s disease, at least among women.”
The results are published online in the journal Neurology.
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A 30-second test to spot the signs of Alzheimer’s in those in their 40s is being developed by scientists.
The simple procedure, which warns of the debilitating disease decades before symptoms show, brings the hope of routine screening for dementia in as little as two years.
Carried out on a computer in a GP’s surgery, the test could become as widely used as blood pressure checks.
Those found to have a tiny piece of tell-tale damage to their brains could take preventative measures such as changing their diet and taking more exercise.
Quicker detection would allow earlier treatment and, with the help of new drugs, some who test positive might never develop the disease.
Alzheimer’s and other forms of dementia affect more than 800,000 Britons, with the number expected to double in a generation.
Professor David Bunce, who led the research, said: ‘The study lays open the possibilities for screening, early detection and intervention. The earlier we can intervene with people vulnerable to eventual dementia, the greater the chances of preventing or delaying the disease onset.’
However, not everyone will want to be told their fate so far in advance.
And there are fears that insurance companies could increase premiums for those who test positive.
Experts say that delaying the onset of Alzheimer’s by five years could halve the number of people who die with the condition, currently a third of over-65s.
At the moment, diagnosis is based on memory tests or expensive brain scans. Proof of the disease often comes only from examination of the patient’s brain after death.
By contrast, the computer procedure, based on a simple test of reaction times, would be quick and easy.
Professor Bunce, of Brunel University, London, used brain scans to find tiny lesions, each smaller than a grain of rice, in the white matter of apparently healthy men and women aged 44 to 48.
Around 15 per cent of the 428 tested had the abnormalities, which occurred in the brain’s memory hub.
Although the research did not show that these people went on to develop dementia, the lesions were similar to those discovered in post-mortem examinations of Alzheimer’s patients – and were found in the same part of the brain.
The professor saw that those with the brain lesions performed more erratically in a test of reaction times, which involved watching for one of two lights on a screen and hitting a corresponding button.
Those with lesions had a mixture of slow and fast reaction times, whereas those with healthy brains had either consistently fast or slow responses, the journal PLoS ONE reports.
The study was funded by research foundation the Leverhulme Trust. Although more research – and funding – is needed, it is hoped the test could be in doctors’ surgeries in two to five years.
It is thought that drugs already on the market would be of little use to combat the disease at such an early stage. However, laboratories around the world are trying to develop pills and jabs that halt Alzheimer’s earlier in their tracks.
In the meantime, Alzheimer’s charities recommend eating a healthy diet and exercising regularly to stave off the disease.
Ruth Sutherland, of the Alzheimer’s Society, said: ‘We know that changes in the brain begin many years before the first symptoms of dementia become evident. It is therefore vital to invest in research into the early signs of dementia in the brain.’