New way to stage Alzheimer's is offering insights into the disease

We classify cancer into different stages - now researchers are doing something similar when it comes to Alzheimer's disease.

And this change could mean earlier diagnosis for many.

Sister Barbara Schlatter has been a nun for 50 years.

She's helped a lot of people during that time, but two people she couldn't help - her parents. They both passed away with Alzheimer's. Now, Sr. Barbara worries about her aging brain.

"When I can't get a word like that, I think, uh oh, is this it?" she says.

Recently, investigators found a way to stage the disease during a period they call preclinical Alzheimer's.

"The data suggests that, um, the pathology starts anywhere from 10 to 20 years before any sign of clinical symptoms,” explains research professor Anne Fagan, Washington University in St. Louis.

Researchers divide pre-clinical Alzheimer's into three stages based on results from spinal fluid and imaging tests.

They studied 311 patients. The preclinical stages are based on biomarkers that indicates how much amyloid plaque and tangle-related proteins are found in the brain and whether or not patients eventually go on to show symptoms of memory decline.

"Once you get dementia, that is actually the end stage,” Fagan adds.

Sr. Barbara hopes the research will one day save others from the heartache she felt watching her parents fade away.

About 31-percent of the 311 patients studied fell into one of the stages.

This percentage matched findings from autopsy studies - suggesting the disease starts long before symptoms develop.

Researchers believe patients with pre-clinical Alzheimer's could be an important target for new therapies.

Interestingly, the investigators found individuals with pre-clinical Alzheimer's were six times more likely to die over the next decade, but they aren't sure why.


REPORT: MB # 3738

BACKGROUND: Alzheimer's disease is an irreparable brain condition that slowly affects brain functioning, eventually leading to dementia. The disease is named after Dr. Alois Alzheimer, who, in 1906, while studying the brain of a recently-deceased woman, found abnormal clumps and tangled bundles of fibers in her brain. These are now called amyloid plaques and neurofibrillary tangles, respectively, and make up two of the three main features of Alzheimer's. The other is the breakdown of neurons, or connections between nerves, in the brain. Together, these three conditions affect key areas of the brain, including the hippocampus, responsible for memories. As more neurons run less efficiently, they eventually die, and brain tissue beings to shrink. (Source:
CAUSES: There is no known cause or cure for Alzheimer's. Despite this, the most important factor to consider with Alzheimer's is that it is a progressive disease. The biggest risk factor for the disease is age. Every five years after the age of 65, your risk of developing the disease doubles, and after age 85 the risk of the disease is 50 percent. Another risk factor is family history. Those with family members who had the disease have a higher risk, and those with multiple family members who had it are at an even higher risk. There is also a belief that head trauma may play a role in causing the disease later in life. Research is also growing relating to heart health and the disease, perhaps linking cardiovascular health and an increased risk of the disease. (Source:
NEW TECHNOLOGY: Starting in 2011, the National Institute on Aging together with Alzheimer's Association, proposed a classification system for the disease. Researchers at Washington University studied the need for such a classification, and not only validated the system, but also developed another system to define what they called preclinical Alzheimer's. Those with preclinical Alzheimer's may seem cognitively normal, but have certain biomarkers believed to associated with Alzheimer's later in life. Split into three stages, preclinical Alzheimer's is the start of a potentially decades long process that ends with the presence of symptoms of Alzheimer's or dementia. (Source:

Judy Martin
Director of Media Relations
Washington University School of Medicine
(314) 286-0105

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