Wednesday 5 July 2017

Spotting the earliest signs of Alzheimer’s

A study to spot the earliest signs of Alzheimer’s, funded by the Medical Research Council and the National Institute for Health Research, is about to begin.

The study, currently funded by the Medical Research Council and the National Institute for Health Research, and supported through the NIHR Dementia Translational Research Collaboration, will work on new ways to detect early signs of the condition, many years before symptoms like memory loss and confusion become obvious.

It is believed that an early diagnosis is crucial to enable people to start receiving medication that can stop Alzheimer’s from developing further.

Finding a treatment that can combat the disease has been one of medicine’s major challenges. Results from drug trials have repeatedly been disappointing.

This new study will involve up to 50 tests on 250 volunteers and will include brain scans, cognitive testing and measure the way people walk.

The difficulty that doctors face is that the disease can start to affect the brain several years before the symptoms are visible.

The Deep and Frequent Phenotyping Study involves eight UK universities and the Alzheimer’s Society. It will aim to find the very earliest signs of Alzheimer’s, between 10 and 20 years before the symptoms become more obvious. Initial studies to support the development of the project were undertaken as part of the NIHR Newcastle Biomedical Research Centre, within which dementia research is a key priority.

Range of rigorous tests

The study includes regular brain scans, cognitive and memory testing, retinal imaging, blood tests and the use of wearable technology to measure movement and gait.

Lynn Rochester, Professor of Human Movement Science at Newcastle University and Director of the Clinical Ageing Research Unit is a key academic in the Deep and Frequent Phenotyping study. Her research is leading the way in understanding gait as a predictor of cognitive decline. Professor Rochester and her team, in part, have been supported by the NIHR Newcastle BRC, and have benefitted from the use of state-of-the-art facilities funded through other areas of the NIHR infrastructure in Newcastle – such as the Clinical Research Facility.

Professor Rochester believes this work is essential within the field of dementia research and that tiny, almost imperceptible changes in the way people walk could be a very early sign of Alzheimer’s disease.

“People think of walking as a task which involves muscles contracting and relaxing and you get from A to B,” she says.

“But in fact walking is now considered as much a cognitive task as it is a motor task and we’ve got a really large body of research that shows that.”

Within the Deep and Frequent Phenotyping Study, researchers are using small devices, fitted to the small of the back, to measure movement over a period of a week. Small changes to the pattern of walking can be indicative of deeper problems in the brain, eventually leading to dementia. Scientists would be looking for variations in walking which could involve changes in speed, balance and unusual movements not explained by normal ageing.

“If you think about your footsteps in the sand, and how even and well placed they are. We’re looking at very, very subtle changes in how those footsteps might appear,” Professor Rochester explains.

The study, described by the researchers as potentially game changing, will monitor and measure small changes on the 250 volunteers over a period of a year. Some of those involved will be at risk of developing Alzheimer’s disease because of their genes or age, and others will not be at risk.

The research will generate huge amounts of data and will use complex big-data mathematical analysis to determine which tests, or combination of tests, best predict later onset of Alzheimer’s.