Researchers from the University of Cambridge have found that signs of dementia can be detected in patients as early as nine years before an official diagnosis.
The research team analysed data from the UK Biobank, identifying several areas of brain impairment as potential signs of dementia. The identified areas of impairment related to problem-solving and number recall, across several conditions.
These findings mean it may be possible to screen and detect at-risk patients even earlier. The patients could benefit from interventions that may reduce their risk of developing dementia and dementia-related conditions. Early screening could also help identify suitable patients to take part in clinical trials for new treatments.
Signs of dementia can be difficult to identify
Currently, there are few effective treatments for dementia and other neurodegenerative diseases such as Parkinson’s disease. One of the reasons treatments have been difficult to develop is that neurodegenerative diseases are typically only diagnosed once symptoms appear. Despite this, neurodegeneration may have been developing in a patient years prior to a diagnosis.
Prior to this research, it has been unclear whether it may be possible to detect signs of dementia in the brain before the onset of symptoms. The University of Cambridge researchers sought to address this by analysing genetic, lifestyle and health information from 500,000 UK participants aged 40-69 years old.
The researchers also examined the results of tests on problem-solving, memory, reaction times and grip strength from the UK Biobank. Data on weight loss and gain and the number of falls were also considered. This allowed the researchers to see whether any signs of dementia were present between five and nine years prior to diagnosis.
Participants who went on to develop dementia achieved worse results compared to healthy participants when it came to problem-solving tasks, reaction times, remembering lists of numbers, and pair matching. Participants who went on to develop dementia were also more likely to have had a fall in the previous 12 months than healthy participants.
A step towards new treatments
“When we looked 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 a number of aspects of cognition,” said Nol Swaddiwudhipong, first author and junior doctor at the University of Cambridge.
“This is a step towards us being able to screen people who are at greatest risk – for example, people over 50 or those who have high blood pressure or do not do enough exercise – and intervene at an earlier stage to help them reduce their risk,” he added.
Senior author Dr Tim Rittman from the Department of Clinical Neurosciences at the University of Cambridge added: “People should not be unduly worried if, for example, they are not good at recalling numbers. Even some healthy individuals will naturally score better or worse than their peers. But we would encourage anyone who has any concerns or notices that their memory or recall is getting worse to speak to their GP.”
The researchers hope their findings will help identify people with signs of dementia who can participate in clinical trials and improve treatment.
“The problem with clinical trials is that by necessity they often recruit patients with a diagnosis, but we know that by this point they are already some way down the road and their condition cannot be stopped. If we can find these individuals early enough, we’ll have a better chance of seeing if the drugs are effective,” said Dr Rittman.