WEDNESDAY, April 6 (HealthDay News) -- MRI brain scans may help
predict which adults with mild cognitive impairment -- early-stage
memory problems that don't interfere with daily living -- are more
likely to develop full-blown Alzheimer's disease, a new study
suggests.
Analyzing baseline MRI exams from the Alzheimer's Disease
Neuroimaging Initiative, a large study of healthy individuals and
others with mild cognitive impairment (MCI) and early Alzheimer's,
scientists calculated that those with MCI had a one-year risk of
progressing to Alzheimer's ranging from 3 percent to 40
percent.
Typically, people with MCI will develop Alzheimer's disease at a
rate of 15 to 20 percent annually, the researchers said, which is
markedly higher than the 1 to 2 percent rate of the general
population.
"In the last few years we've seen a real explosion of biomarkers related to Alzheimer's disease," said lead study author Linda McEvoy, assistant professor of radiology at University of California-San Diego School of Medicine. "Our ability to detect this has improved. I wasn't surprised by the strength of the results."
Affecting about five million Americans, Alzheimer's gradually
robs patients of memory, language skills and judgment before
rendering them incapable of caring for themselves. MCI, which does
not always progress to Alzheimer's, is more serious than normal
age-related decline but does not reflect the significant
deterioration of Alzheimer's dementia.
The new study, published online April 6 and in the June print
issue of the journal
Radiology, showed a pattern of thinning in the brain's
cerebral cortex -- the outermost layer of the cerebral hemispheres
that plays a key role in memory, attention, thought and language --
among patients more likely to develop Alzheimer's. (One of the
hallmarks of Alzheimer's is a loss, or atrophy, of brain cells in
certain areas of the cortex.)
The study data, gathered between 2005 and 2010, included a
baseline MRI exam to serve as an initial measurement and a second
MRI performed a year later on 203 healthy adults, 317 patients with
MCI and 164 patients with late-onset Alzheimer's disease. The
patients' average age was 75.
By combining the results of the two MRIs, the researchers
calculated that the MCI patients' risk of disease progression
ranged from 3 percent to 69 percent, with an average group risk of
27 percent.
"The study is pretty robust," said Bill Thies, chief medical and scientific officer of the Alzheimer's Association. "It's an area of great activity and interest at the moment. This paper is a really good attempt to sort out biomarker information."
But experts pointed out that an enhanced ability to predict who
will develop Alzheimer's is not accompanied by the ability to
forestall its terrible prognosis. While several drugs can
temporarily improve thinking skills in some early-to mid-stage
Alzheimer's patients, no treatments exist that prevent or cure the
condition.
"We're looking at changes in a disease that has a long asymptomatic period ... that probably goes on for a couple of decades before showing symptoms. We probably do want to go to a point where we can pick out people before symptoms show, but we have nothing to treat them [with]," said Dr. Raj C. Shah, medical director of the Rush Memory Clinic in Chicago. "It's a little bit of chicken and egg, but we have to start somewhere -- and an advance in one area helps advance another."
McEvoy and Thies said early detection could help patients in
other ways, however. Some may gain access to cutting-edge clinical
drug trials, while the information could offer patients and their
families time to plan for future needs, such as caregiving.
Even those untouched by Alzheimer's disease stand to benefit
from this type of research, Thies noted.
The incidence of Alzheimer's disease "is going to get acutely
worse in the next four years and will bankrupt the health care
system," he said. "So this kind of work is critically important to
everyone. Because of the cost and increase in frequency, it's going
to be a major driver of health care costs."
Although McEvoy said she doesn't think "there are big barriers
to be able to use this clinically," she and the other experts
agreed more research is needed before MRIs for Alzheimer's
diagnosis become commonplace.
"At some point we will be able to tell people about their risk before they have any symptoms, and in a perfect world we could treat symptoms before they emerge," Thies said. "Just like we treat high blood pressure to avoid heart attack and stroke, clearly this is a model we're going to see emerge."
More information
The Alzheimer's Association has more information
about symptoms.