Subtle differences in cognitive performance predict progression to Alzheimer's pathology

Subtle differences in cognitive performance predict progression to Alzheimer's pathology

Reviewed by Kate Anderton, B.Sc. (Editor) Feb 16 2020 Alzheimer's disease (AD) is progressive, but slow to develop -- or at least to reveal itself. In a new study, published online February 14, 2020 in the journal Biological Psychiatry , researchers at University of California San Diego School of Medicine, with colleagues elsewhere, report that early, subtle differences in cognitive performance, such as fewer words recalled on a memory test, are a sign that harmful proteins are accumulating in the brain, even if levels of those proteins do not yet qualify as dangerous. Pathologically, AD is primarily characterized by the accumulation of protein plaques called β-amyloid (Aβ), which gradually accumulate in the brain, disrupting cell function and eventually killing affected neurons. A second type of protein, called tau, also accumulates abnormally inside neurons, damaging functions. In the progression of AD, Aβ levels build in the brain, but the process leading to abnormally high levels is typically long. It is often years or decades before consequential symptoms of severe cognitive impairment appear. A new framework from the National Institute on Aging and Alzheimer's Association defines the first stage of AD to be individuals with abnormal levels of Aβ who are still cognitively normal. Although AD pathology, and Aβ in particular, appear long before severe cognitive deficits appear, recent evidence suggests more subtle cognitive changes may appear earlier in the disease than commonly appreciated." Jeremy A. Elman, PhD, first author, assistant professor in the Department of Psychiatry at UC San Diego School of Medicine Elman and colleagues, including senior author William S. Kremen, PhD, professor of psychiatry at UC San Diego School of Medicine, sought to determine whether poor cognitive performance, however subtle, might be a predictor that current Aβ-negative levels (accumulations below the threshold for AD diagnosis) were likely to become Aβ-positive. Related Stories



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