Alzheimer's Disease Current Topics in Alzheimer's Disease

The Future of Preventing Alzheimer's Moves Closer to Reality

As researchers scramble to find new treatments for the growing number of Americans with Alzheimer's disease, some of the most dramatic developments are happening in the area of prevention and early detection.

Studies increasingly show how certain lifestyles, such as keeping mentally engaged, eating a heart-healthy diet and staying physically active may protect against Alzheimer's. In addition, new research shows that the first signs of decline may begin years before someone is diagnosed with the memory-robbing disease, offering a chance for doctors to intervene early.

Dr. Ronald Petersen, director of the Alzheimer's Disease Research Center at the Mayo Clinic in Minnesota, discovered a type of pre-dementia stage, known as mild cognitive impairment (MCI). People who develop this early, more severe type of memory problem have a higher chance of progressing to Alzheimer's. Other teams have since found that the signs of Alzheimer's may start even earlier, prompting researchers to search for tests that may help predict who is at risk. Dr. Petersen discusses the latest findings and the steps people can take to prevent the disease.

When do people first begin to show signs that may indicate a greater risk of Alzheimer's?
If you look at the development of Alzheimer's on a continuum, those individuals who are going to develop it start out with normal memory. Then, they go through this transitional phase that we've called mild cognitive impairment, where people are slightly impaired, usually in memory.

And then as things progress even beyond that, they develop the full-blown signs of Alzheimer's disease. A recent study from Sweden indicated that even when people are normal—before the MCI stage—there may be some subtle features of cognitive decline that warn of greater changes in the future. In fact, some of the symptoms of Alzheimer's disease really begin as much as a decade or more before the clinical diagnosis is made.

There are some subtle features, such as memory impairment, trouble with processing multiple pieces of information and difficulty concentrating on what's going around us. These changes may indicate that a person is more likely to develop Alzheimer's disease in the future.

Is there a way to test whether someone is at risk for Alzheimer's?
I think that there are some hints now that we may be able to pick up the very earliest signs of the disease. There may be some measurement of performance—such as memory and thinking—that will indicate a person who might be susceptible to developing Alzheimer's disease. We may need to augment that with brain imaging techniques to measure the size of certain structures in the brain that are critical for learning and remembering.

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