Study shows how to detect Alzheimer’s disease before symptoms show

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A researcher at the University of Missouri has recently completed research on producing methods for defining the presymptomatic stages of Alzheimer’s disease, according to a Nov. 11 news release from the school.

Andrew Kiselica, an assistant professor in the MU School of Health Professions, was inspired to work on identifying and halting neurodegenerative diseases like Alzheimer’s after both of his grandfathers developed dementia while he was in graduate school.

“Most families have had this experience of watching someone who is vibrant and full of life essentially turn into someone they can barely recognize,” Kiselica said in a statement. “I don’t want people to have to go through that as their last phase of life. The experience with my grandparents has been the driving force behind my desire to study this disease.”

For his study, Kiselica reviewed data from the National Alzheimer’s Coordinating Center to review over 400 individuals who had been deemed “cognitively normal." He especially focused on 101 of the individuals who had a buildup of Alzheimer’s disease-linked amyloid plaque in the brain.

Kiselica analyzed the data that included information such as caregivers' observations on cognitive decline and neurobehavioral symptoms like anxiety and depression. Then, he discovered — as expected — the individuals with the amyloid plaque in their brains were more likely to show Alzheimer 's-related symptoms as opposed to individuals without the amyloid plaque. He also noticed that 42% of individuals with amyloid plaque had no symptoms of cognitive decline.

“We have developed clear procedures for classifying individuals who are asymptomatic or symptomatic in the preclinical stages of Alzheimer’s disease,” Kiselica said. “This is important because if a drug to treat Alzheimer’s is approved by the FDA down the road, the drug will likely be most effective on those with Alzheimer’s-related changes in the brain but no outward signs of cognitive decline yet.”

He noted that his research can help the developers of future medications meant to treat Alzheimer’s disease or dementia know what sort of people to include in their clinical trials since people who show signs of the condition could take a proposed Alzheimer’s drug that will possibly be ineffective. This is because the disease cannot be reversed once symptoms are present.

Kiselica’s study was published about a month before the Food and Drug Administration met to discuss approval of the first drug to treat Alzheimer’s disease in 20 years. However, Time magazine reported that during the seven-hour meeting, hopes of approval were stamped out as the FDA advisory committee expressed a list of concerns about the presentation of data tied to the drug, aducanumab, and the agency’s interpretation of that information.

“I don’t think the evidence from [the positive study] provides substantial evidence on the efficacy or the effectiveness of this drug,” committee member Dr. Aaron Kesselheim, associate professor of medicine at Harvard Medical School and Brigham and Women’s Hospital said.