Alzheimer’s Disease (AD) is a neurological
disorder in which plaques build up between neurons and neurofibrillary tangles form
within neurons, disrupting communication. Typical AD patients initially exhibit
memory loss as their main symptom. Atypical Alzheimer’s Disease is
characterized by initial symptoms of damage to visual, motor, language,
behavioral, and executive functions, rather than memory. This difference in
presentation of the disease can lead to misdiagnosis, which can negatively
affect patient outcomes as treatments, planning, and resources are delayed. Additionally,
a disproportionate amount of atypical AD patients have young onset dementia (symptoms
appear before age 65), and a majority of supports for AD patients are geared
towards older adults in a later stage of life.
This article I read provides an
in-depth analysis of the consequences of delayed diagnosis, as well as recent
research into how biomarkers can aide in detection of atypical AD. It also talks
about benefits of individualized treatment and how researching atypical AD can
provide unique insight to expand our understanding of the disease as a whole. Expansion
of biomarker technology to include diverse phenotypic expression of AD can help
with early diagnosis, which is essential for ensuring patients get treatment and
proper support as soon as possible. This research is also important for further
understanding of atypical and early onset AD. The researchers recommend future clinical
studies to include diverse phenotypes aside from just memory related symptoms
in order to expand our understanding of this disease we still know so little
about.
I find this topic particularly interesting because there are so many things we do not know about our bodies and the processes that relate to Alzheimer’s disease. In their suggestions for future research, the researchers mentioned a need to determine whether there are links between AD and early brain development. This could open up a whole new world of possibilities for treatment and even possibly prevention of Alzheimer’s disease, as it is currently a disease for which we have no cure. I love thinking about how a new angle or aspect of understanding could change the entire landscape of research on this disease and others.
Source: Graff-Radford, J., Yong, K. X. X., Apostolova, L. G., Bouwman, F. H., Carrillo, M., Dickerson, B. C., Rabinovici, G. D., Schott, J. M., Jones, D. T., & Murray, M. E. (2021). New insights into atypical Alzheimer's disease in the era of biomarkers. The Lancet. Neurology, 20(3), 222–234. https://doi.org/10.1016/S1474-4422(20)30440-3
Super interesting, although somewhat depressing topic. Biomarkers are super important for early diagnosis, but also help us learn about how the disease may develop as well. I know your post focused mainly on AD in early development, but this article I found talks about the relationship between the gut microbiota and development of AD during aging. The article also mentions how the gut microbiota is related to obesity and type 2 diabetes. Wouldn't it be interesting if a potential biomarker could come out of this axis?
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Jiang C, Li G, Huang P, Liu Z, Zhao B. The Gut Microbiota and Alzheimer's Disease. J Alzheimers Dis. 2017;58(1):1-15. doi: 10.3233/JAD-161141. PMID: 28372330.
I found this super interesting, thank you for your thoughts! I wanted to share some interesting tidbits I learned recently from a paper I did a presentation on. This paper was on tuberculosis and a common effect of a TB infection is pervasive whole body inflammation that also makes its way into the brain. Even though the bacteria does not cross the blood brain barrier, there are numerous cytokines released that cause proliferation and phenotypical changes in the brain's glial cells that cause serious neurodegeneration and misfolding of proteins. These misfolded proteins are beta amyloid and hyperphosphorylated Tau, both hallmarks of Alzheimer's. I wonder monitoring for Alzheimer's after a major bacterial infection such as TB could be a way of diagnosing Alzheimer's earlier as you mentioned is desperately needed.
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