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Early Complaints About Memory Issues Linked to Alzheimer's-Related Changes

New research suggests that people who report early signs of memory problems may already have elevated levels of amyloid plaque and tau tangles in the brain.

The road to an Alzheimer's Disease diagnosis often begins with slight hints of memory loss, such as difficulty recalling recently learned information, or forgetting appointments or the names of ordinary household items. People experiencing these issues may even complain about their memory to others.

The individual's partner or family might also notice slight shifts in memory and thinking. Still, standard tests for Alzheimer’s may show the person has normal cognitive functioning at this stage.

Scientists believe that treating Alzheimer's and dementia early on in the disease is essential to slow how fast it progresses. However, healthcare providers typically won't start treatments until the person is diagnosed through cognitive testing and brain scans.

Bridging the time gap between early hints of memory problems and clinical diagnosis could ensure a person with Alzheimer's receives treatment as early as possible.

In a study published on May 29 in the online issue of Neurology, the medical journal of the American Academy of Neurology, scientists from Mass General Brigham investigated whether complaints from individuals and their family members about early memory issues are linked to Alzheimer's-related brain changes.

If so, it could lead to earlier detection of the disease.

Early memory issues and Alzheimer's biomarkers

To conduct the research, the team recruited 675 adults with an average age of 72 who did not have diagnosable cognitive impairment. Each participant underwent a brain scan to detect amyloid plaques and tau tangles, which may indicate an increased risk of developing Alzheimer's.

The participants and their child, spouse, or close friend also filled out questionnaires to determine whether they or their loved one noticed any memory issues. A higher score indicated more memory and thinking problems.

The scans showed that 60% of the participants had elevated amyloid plaque levels in their brains. After reviewing the questionnaire results, the research team found that individuals with higher scores were more likely to have higher amyloid plaque levels.

Moreover, when the scientists looked for tau tangles in the brain scans, they discovered that participants with elevated levels of tau tangles—especially those with more amyloid plaques—had higher scores on the memory questionnaire. Their loved ones' responses also scored higher.

The study participants were primarily highly educated white individuals, so it's unclear whether the results would be the same in other groups. However, according to the researchers, these findings suggest that asking older individuals about their memory issues may help identify the disease earlier, resulting in early treatment.

"We now understand that changes in the brain due to Alzheimer's disease start well before patients show clinical symptoms detected by a doctor," said study co-author Rebecca E. Amariglio, Ph.D., of the Department of Neurology at Brigham and Women's Hospital, in a press release. "There is increasing evidence that individuals themselves or a close family member may notice changes in memory, even before a clinical measure picks up evidence of cognitive impairment."

Therefore, the researchers say it is also important to ask family members about memory or thinking problems they've observed in their loved one, as the answers could help bridge the time gap between the initial onset of cognitive issues and an Alzheimer's diagnosis.

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