Test may predict Alzheimer's risk years in advance

December 1, 2010

As many as 5.3 million Americans are living with Alzheimer's disease. It destroys brain cells, causing memory loss and problems with thinking and behavior severe enough to affect work, lifelong hobbies or social life.

Alzheimer's gets worse over time, and it is fatal. Today it is the sixth-leading cause of death in the United States.

DIAGNOSES: It has no current cure. There is no single test that proves a person has Alzheimer's. The medical workup is designed to evaluate overall health and identify any conditions that could affect how well the mind works.

Experts estimate a skilled physician can diagnose Alzheimer's with more than 90 percent accuracy. Doctors can almost always determine that a person has dementia, but it may sometimes be difficult to pin down the exact cause.

The mini-mental state examination (MMSE)is one of the tests most commonly used to assess mental function. In the MMSE, a health professional asks a patient a series of questions designed to test a range of everyday mental skills. The maximum MMSE score is 30 points. A score of 20 - 24 suggests mild dementia, 13 - 20 suggest moderate dementia, and less than 12 indicates severe dementia. On average, the MMSE score of a person with Alzheimer's declines about 2 - 4 points each year.

LOOKING INTO THE FUTURE: Researchers at the University of Pennsylvania have found a way to determine the risk for developing Alzheimer's in patients who have mild memory problems with a test that measures proteins in the spinal fluid.

In a study, which was published in the Archives of Internal Medicine, researchers looked at a trio of three proteins, or biomarkers, that formed a "signature" pattern in the spinal fluid, the liquid that bathes the brain and spinal cord. The three proteins are known as cerebrospinal fluid beta-amyloid protein 1-42, total CSF tau protein, and CSF phosphorylated tau 181P. They found that 90 percent of those with Alzheimer's had the amyloid protein in their spinal fluid. The disease pattern was present in 72 percent of those with mild cognitive impairment and 36 percent of those who were normal.

The findings must be confirmed with additional studies, and easy-to-implement versions of the test would need to be made available.

The procedure requires a spinal tap, which is not currently a routine part of doctor office visits. The goal with this test is to identify people who are getting the disease and enroll them in treatment trials to slow the decline.


Leslie Shaw, PhD
University of Pennsylvania Medical Center
Center for Neurodegenerative Disease Research

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