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Scientists pinpoint earliest ever Alzheimer’s signs

Early-onset dementia is rare but distressing.

Researchers have found brain changes caused by Alzheimer’s disease in a group of 20-somethings, marking the earliest ever detection of early-onset dementia warning signs and paving the way for new treatments.

Alzheimer’s disease is one of the biggest causes of disability in Australians over 65 but can also affect people in their 40s, a form of the disease known as early-onset Alzheimer’s disease.

Early detection boosts a person’s chances of fighting dementia.

Researchers from the US and Colombia studied a group of people aged 18 to 26 who carried a gene mutation that made them more vulnerable to early-onset and familial Alzheimer’s disease.

By comparing them to non-carriers of the gene mutation, the scientists were able to detect certain proteins in blood and cerebrospinal fluid and brain changes – early warning signs that could be unearthed up to 25 years before symptoms set in.

“This study shows the earliest known biomarker changes in cognitively normal people at genetic risk for autosomal dominant Alzheimer’s disease,” said the study, titled Brain imaging and fluid biomarker analysis in young adults at genetic risk for autosomal dominant Alzheimer’s disease in the presenilin 1 E280A kindred: a case-control study and published today in The Lancet Neurology.

Associate Professor Michael Valenzuela, Leader of Regenerative Neuroscience Group, at the University of Sydney’s Brain & Mind Research Institute said understanding how early-onset and familial Alzheimer’s disease worked was vital to developing new treatments and when treatment should start.

“Early-onset and familial Alzheimer’s disease is relatively uncommon but terribly distressing for the individuals and their family,” said Prof Valenzuela, who was not involved in the study.

Prof Valenzuela said the research was the most comprehensive study of group of related people carrying the gene mutation so early in the disease process but that its findings also posed difficult questions.

“If we are to intervene to help stop or slow the disease, when? Clearly, 20 years before symptoms there are already major brain changes; does that mean we need to intervene even earlier (adolescence or childhood)? How realistic is this, particularly if such an intervention were to have significant risks?”

Prof Valenzuela said follow up studies were needed.

“Finally, whether these findings have any relevance to the vast majority of those with Alzheimer’s dementia that is not early onset or familial remains entirely unknown.”

Ian Musgrave, Senior lecturer in Pharmacology at the University of Adelaide, said the study was very significant.

He said it would be interesting to know if the findings also apply to people who suffer from late-onset Alzheimer’s disease that do not carry the genetic mutation present in this study’s group of subjects.

“Then a simple blood test may be possible in the future which can indicate people at risk.”

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