Dementia...the new hope

Simple blood test can predict the onset of Alzheimer's before symptoms actually appear

By Dr Miriam Stoppard

A piece of news concerning dementia cheered me up no end this week. It was that a simple, cheap blood test to predict the onset of Alzheimer's, the most common form of the condition, may be available in just three years.


At the moment there's no definitive test and dementia is diagnosed by assessing symptoms and mental abilities and running tests to rule out other conditions. Brain scans can detect it but it is difficult in the early stages.

What's so great about this potential test is that it would be an easy way to predict the condition in advance. The test would measure levels of a blood protein called clusterin, which increases years before symptoms actually appear.

Researchers at the Institute of Psychiatry, King's College London, studied levels of clusterin in 300 people, some with Alzheimer's, some with mild memory problems and some with normal brain function. They found that higher levels of clusterin were associated with brain shrinkage and memory and cognitive problems. Previous research in the US indicated that high clusterin levels could be present 10 years before symptoms show up.

Early warning

But would you want to know your fate? My answer is yes! There may be no outright cure yet but forewarned is forearmed. Diagnosis is often delayed because it's not clear whether symptoms are just normal age-related memory loss or dementia.

Yet early diagnosis helps people adjust both emotionally and practically, and leads to earlier treatment, easing symptoms and slowing the disease. Doctors may, understandably, not want to prescribe drugs when it's not clear whether a patient actually has dementia. An accurate test would remove this doubt.

This clusterin discovery may pave the way for preventative treatments. This may be useful for people with a family history of dementia or those with conditions that raise risk such as Type 2 diabetes.

Is it linked to depression?

A second pleasing item of news this week suggested that depression increases the risk of dementia, not the other way round. One study, which followed nearly 1,000 people for 17 years, showed that dementia more often came after a bout of depression.

Another study of 1,200 people showed that the more times someone had been depressed, the higher their dementia risk. Inflammation of brain tissue and production of certain proteins in depression may play a role in dementia but researchers are quick to emphasise that this doesn't prove a direct cause.

So why do I think this is good news? Again, it helps us pinpoint who may need help, leading to earlier diagnosis and treatment. And again, knowing more about the chemical process could help pave the way for more effective treatments.

Dementia affects an estimated 750,000 Brits and experts predict that rates will double every 20 years, mainly due to increased life expectancy. This will make it one of the leading medical challenges of the 21st century - one I'm sure scientists will meet.

Seven brain savers

  1. Get out of the smoke - Last year a US study found that under-55s who smoke are five times more likely to get dementia than those who've never smoked. It's never too late to stop! Visit www.smokefree.nhs.uk for help.
  2. Lose the spare tyre - Obesity can increase dementia risk by 80%, according to researchers from the US Johns Hopkins Bloomberg School of Public Health. Fat around the middle is thought to be riskiest.
  3. Get an MOT - All adults should have blood pressure and cholesterol tests but it's especially important from middle age onwards. High blood pressure and cholesterol are risk factors for dementia as well as heart disease and stroke. It also makes sense to rule out Type 2 diabetes, another known risk factor that's on the increase, due to a rise in obesity.
  4. Protect your brain - Eat foods including nuts, olive oil, oily fish such as salmon, sardines and mackerel, wholegrains and broccoli.
  5. Drink safe - Booze can lead to furring of the arteries, increasing your risk. Go to www.drinkaware.co.uk.
  6. Go for a walk - Brisk walking three times a week has been found to lower risk in over-65s by 40%.
  7. Stay sharp - There's no evidence that 'brain training' computer games makes dementia less likely, but keeping your brain active may help it function.

Is it really dementia?

Symptoms include:

  • Short-term memory problems
  • Gradual loss of reasoning power
  • Difficulty concentrating or carrying on a conversation
  • Mood swings
  • Confusion
  • Wandering and getting lost

If you're worried, see your GP. Some drugs aren't available on the NHS until the condition is classed as moderate, but I believe it's still worth getting an early diagnosis.

First, even if your primary care trust won't fund drugs for mild dementia, you can get them on private prescription through a consultant, GP or private hospital. There are proven benefits for some patients, though not all. This will not jeopardise the rest of your NHS care.

But even if you don't have the drugs until later, you can get advice, support and other treatments including cognitive stimulation - exercises designed to boost memory - and reality orientation therapy, which tackles mental disorientation.

Pic: Mokra

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