Guest Author, Robert Best, Executive Director Oak Hill Terrace
There are individuals who are genetically destined to develop a rare and aggressive form of the Alzheimer’s Disease. Carriers of this genetic mutation (Dominantly Inherited Alzheimer’s Network or DIAN) develop this autosomal-dominant Alzheimer’s Disease in their 40s but it can strike as early as the 20s.
The first published study of these individuals suggest that changes may begin in the brain up to 25 years before symptoms of the disease begin to appear.
"A series of changes begins in the brain decades before the symptoms of Alzheimer's disease are noticed by patients or families, and this cascade of events may provide a timeline for symptomatic onset," first author Randall Bateman, MD, Washington University School of Medicine in St. Louis, Missouri, said in a statement. "As we learn more about the origins of Alzheimer's to plan preventive treatments, this Alzheimer's timeline will be invaluable for successful drug trial," Dr. Bateman added.
One of the challenges of understanding late-onset Alzheimer’s is that the disease develops over many years, yet diagnosis occurs after an individual becomes symptomatic.
For those individuals with autosomal-dominant Alzheimer’s Disease, the onset of the disease can be predicted. Researchers used the participants' age at baseline assessment and their parents' age when symptoms of the disease began, to calculate the estimated years to symptom onset. They were then able to identify several biochemical changes that occurred 10-25 years before the expected onset of symptoms.
Although there are no immediate clinical implications, what researchers hope is that in the future, we may be able to treat Alzheimer’s 15 years before dementia occurs and prevent its onset altogether. Whether these findings can be generalized to late-onset Alzheimer’s is not yet proven, but there are reasons to think that dominantly inherited Alzheimer’s is the same as the disease that occurs much later in the rest of the population.
Researchers offer an expanded registry for families with inherited Alzheimer's mutations. Anyone with a family history of multiple generations of Alzheimer’s diagnosed before age 55 can visit www.DIANXR.org to register for follow-up contact from researchers to determine whether their family is eligible for participation in DIAN studies.
Robert Best is Executive Director of Laureate Group’s Oak Hill Terrace community in Waukesha. He is a licensed health care administrator and has almost 30 years of experience working with older adults in a variety of settings, including skilled nursing facilities, senior housing, home care and assisted living. He is a fellow in the Wisconsin Geriatric Education Center, an author of numerous books and articles on aging and has presented at conferences across the United States, including the American Society of Aging and National Council on Aging.