Dementia: How falls, poorer health may help predict earlier diagnosis up to 9 years

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More than 55 million peopleTrusted Source around the world have dementia — a group of conditions affecting a person’s brain function.
Although there is currently no cure for dementia, the earlier a doctor can diagnoseTrusted Source a person with dementia, the better in terms of symptom management, treatmentTrusted Source, and slowing its progression.
Now, a team of researchers from the University of Cambridge shows it is possible to view dementia signs in people as early as nine years before they receive a diagnosis.
This study was recently published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.
What is dementia?
Dementia impacts the brain, making it difficult to remember things, communicate, or accomplish everyday tasks like driving or using a cell phone.
The umbrella term dementia encompasses a number of neurological conditions, including:
• Alzheimer’s disease
• dementia associated with Parkinson’s disease
• vascular dementia
• Pick’s disease (frontotemporal dementia)
• Creutzfeldt-Jakob disease
Most people begin to show signs of dementiaTrusted Source in their mid-60s, however, some can begin as early as their 30s.
There are a number of early warning signs that doctors look for when diagnosing dementia. These include:
1. loss of memory that disrupts everyday life
2. confusion with dates, times, and places
3. difficulty managing normal tasks at home or work
4. communication issues
5. constantly misplacing items
6. balance issues
7. difficulty solving problems
8. withdrawn from social activities
9. mood and/or personality changes
10. decreased judgment skills
Signs 9 years before diagnosis
According to Dr. Tim Rittman, senior clinical research fellow in the Department of Clinical Neurosciences at the University of Cambridge, honorary neurology consultant at the Addenbrookes Memory Clinic in Cambridge, and senior author of this study, the team was trying to find how early it is possible to detect changes in memory, thinking, and day-to-day function that might be caused by a progressive brain disease, such as Alzheimer’s disease, Parkinson’s disease, and other similar conditions.
“One of the criticisms of clinical trials of drugs to target progressive brain diseases is that they have captured disease too late, at a time when it may not be possible to change the course of (the) disease,” he explained to Medical News Today. “It has not been clear how early it is possible to detect changes in the brain in these diseases.”
“Some evidence from genetic types of dementia suggests that changes happen years before the diagnosis is made, but until now it has been much more difficult to prove this is true for non-genetic types of dementia and other progressive brain diseases,” Dr. Rittman continued.
“If we can catch progressive brain diseases at the earliest stage we might be able to stop them (from) progressing with changes in lifestyle or new drugs.”
— Dr. Tim Rittman
For this study, Dr. Rittman and his team used data from the UK Biobank, which includes medical information from more than 500,000 people recruited between 2006–2010 at ages 40–69.
Upon analysis, researchers found those who eventually developed Alzheimer’s disease scored poorly on tests related to problem-solving tasks, reaction times, remembering lists of numbers, pair matching, and prospective memoryTrusted Source than people who did not develop dementia. Participants took these tests five to nine years before receiving a dementia diagnosis.
People who developed Alzheimer’s were more likely to have had a fall than those who did not. And researchers found for most dementia conditions studied, people reported poorer overall health at baseline.
Helping prevent future decline
When discussing the next steps for this research, Dr. Rittman said in this study his team used only memory and thinking tests and surveys about people’s day-to-day functions. Including extra tests, such as brain scansTrusted Source or blood tests, might allow them to even better predict a person’s risk of dementia.
“At the moment, we would like to see people use these tests to select people for clinical trials of drugs to slow or stop progressive brain diseases,” he said.
“We would also like to see these tests choose people for diet and lifestyle change to try and prevent future decline in progressive brain diseases to preserve memory, thinking, and mobility,” he added.
Preventive strategies for dementia
Medical News Today also spoke with Dr. Scott Kaiser, a geriatrician and director of geriatric cognitive health for the Pacific Neuroscience Institute in Santa Monica, CA, about this study.
He found this study “validating and important” because although clinicians already know certain things like biomarkersTrusted Source, PET scansTrusted Source, and blood tests can show pathological changes of neurodegeneration many years ahead of symptoms, this study shows there are more subtle symptoms that could also be predictive.
“This is really important because if we could better identify those who are at risk of developing dementia and other neurodegenerative conditions, we have a better chance of intervening early to do something about it. And that can be intervention through lifestyle changes, through changes of managing other known risk factors like vascular risk factors (such as) high blood pressureTrusted Source. And it also can help us better select people for clinical trials to study new potential treatments.”
— Dr. Scott Kaiser
“This is the key — identifying people early so that we can intervene early and really begin to engage true preventive strategies,” he added.
When it comes to the next steps for this research, Dr. Kaiser said he would like to see additional refinement to have a strong predictive risk model where doctors can detect people who are at higher risk earlier and route them into supportive programs to help reduce their risks, such as exerciseTrusted Source programs and nutritional supportTrusted Source.
“There have been successful interventions where in targeting those known risk factors, we can actually reduce people’s risk significantly, bordering on just potentially preventing altogether some cases from ever occurring,” Dr. Kaiser said.
“One of the real keys to the success of those kinds of interventions is finding those people (with) that hidden and rising risk. … And we need that — we’re looking at 150 million people living with dementia in the coming decades if we don’t find effective ways to prevent or otherwise modify this disease course,” he added.