Alzheimer’s warning sign that could appear years before other symptoms

Doctors have issued a warning that a sign of Alzheimer’s could manifest years, possibly even decades, before other symptoms become apparent.

Research suggests that an individual’s ability to navigate could be a predictor of the disease, appearing years before other symptoms.

A recent study has shown that those at risk of Alzheimer’s exhibit impaired spatial navigation prior to experiencing issues with other cognitive functions, such as memory.

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These findings could potentially lead to the creation of a diagnostic support tool for the NHS in the future. The research, led by UCL researchers, utilised virtual reality to test the navigational abilities of 100 asymptomatic adults aged between 43 and 66 approximately 25 years younger than their estimated age of dementia onset.

The study found that those at a higher risk of developing Alzheimer’s disease struggled with the VR navigation task, despite not showing impairment on other cognitive tests. Interestingly, the researchers also discovered a significant gender difference in performance, with the impairment being observed in men but not women.

This suggests that impairments in spatial navigation may begin to develop years, or even decades, before any other symptoms appear, according to the experts. Dr Coco Newton, the first author of the study from UCL Institute of Cognitive Neuroscience, stated during her time at the University of Cambridge: “Our results indicated that this type of navigation behaviour change might represent the very earliest diagnostic signal in the Alzheimer’s disease continuum when people move from being unimpaired to showing manifestation of the disease.”

Research participants recruited for the report were part of the PREVENT-Dementia prospective cohort study and were identified as having either genetic, familial or lifestyle risks relating to Alzheimer’s. This included those with a specific predisposition gene, family Alzheimer’s history, or lifestyle factors such as limited physical activity.

Under the guidance of Professor Dennis Chan, the study utilised a test created by Dr Andrea Castegnaro and Professor Neil Burgess wherein subjects navigated a virtual environment donning VR headsets.

Building on these research outcomes, Dr Newton explained: “We are now taking these findings forward to develop a diagnostic clinical decision support tool for the NHS in the coming years, which is a completely new way of approaching diagnostics and will hopefully help people to get a more timely and accurate diagnosis.”

“This is particularly important with the emergence of anti-amyloid treatments for Alzheimer’s, which are considered to be most effective in the earliest stages of the disease.”

“It also highlights the need for further study of the differing vulnerability of men and women to Alzheimer’s disease and the importance of taking gender into account for both diagnosis and future treatment.”

The research, published in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association, was carried out in collaboration with the University of Cambridge and jointly funded by the Alzheimer’s Society and an MSD research grant.

Dr Richard Oakley, associate director of research and innovation at Alzheimer’s Society, said: “One in three people born today will go on to develop dementia, and early and accurate diagnosis of the diseases that cause the condition are vital for people to access the right support, plan for the future, and receive appropriate treatment.”

“Very early symptoms of dementia can be subtle and difficult to detect, but problems with navigation are thought to be some of the first changes in Alzheimer’s disease.”

He added: “More work is needed to develop this technology, but it will be exciting to see how this research may offer a way to spot disease-specific changes early and help people living with dementia in future.”