Alzheimer’s disease is a progressive neurodegenerative condition impacting millions across the globe. It is characterized by a lengthy preclinical phase that may begin years before noticeable symptoms emerge.
According to recent research, a combination of blood biomarkers and self-reported memory issues might provide early insights into the development of Alzheimer’s disease over a person’s lifetime.
Midlife could, therefore, be a crucial period for promoting brain health.
In our study, we utilized data from the renowned Dunedin Study at the University of Otago, which has been tracking a group of individuals for over five decades.
Our findings revealed that a protein called pTau181 correlates with self-reported memory and cognitive concerns.
Remarkably, the study participants were only 45 years old at the time of assessment, yet dementia diagnoses typically occur in the 70s or later.
Recent years have seen progress in pharmaceutical treatments for Alzheimer’s disease. However, these treatments are not cures; they can slow disease progression but do not restore lost cognitive functions from advanced stages.
These treatments are likely most effective when administered early, highlighting the importance of detecting the initial signs of Alzheimer’s disease.

Preventing dementia
Various types of dementia may appear similar in the early stages, but their treatment and progression can differ significantly.
Historically, Alzheimer’s disease was only confirmed postmortem or through invasive procedures like lumbar punctures.
Researchers are currently working on blood biomarkers that might provide a less invasive method to identify individuals at higher risk of Alzheimer’s disease.
Early detection of Alzheimer’s disease could open up preventive opportunities, offering significant benefits for brain health and aging.
Prevention might include lifestyle modifications, encouraging physical activity, maintaining social engagement, and addressing modifiable risks like hypertension or hearing loss.
Preventive strategies are more effective when started early. Studying middle-aged groups is key to identifying early risk profiles for Alzheimer’s long before any diagnosis.

When forgetfulness becomes a sign of disease
Aging often brings a decline in memory, which is common and usually harmless. However, for some, these memory lapses may suggest other underlying issues.
Recent studies indicate that subtle cognitive changes can occur well before a diagnosis, potentially being the initial indication of the disease.
Assessing biological markers alongside subjective memory reports could help differentiate early Alzheimer’s disease signs from typical aging.
Proteins like pTau181 are significantly elevated in Alzheimer’s patients, though the onset of this accumulation remains unclear.
Our research adds to the evidence that early dementia signs might appear well before diagnosis. Self-reported cognitive issues could be an early Alzheimer’s warning, even in midlife.
Interestingly, we did not observe a correlation between pTau181 levels and MRI brain scans or cognitive tests at age 45.
There are two possible explanations for this.
pTau181 might increase in Alzheimer’s early stages, when memory decline is first noticed, without MRI changes showing yet.
Related: A Signal of Cognitive Decline May Be Hidden in The Way You Write
Alternatively, elevated pTau181 might not be linked to Alzheimer’s risk in midlife, potentially being relevant only in older adults.
Our understanding is still limited, but we will continue monitoring this group as they age to further our research.
Ashleigh Barrett-Young, Research Fellow in Brain Health, University of Otago
This article is republished from The Conversation under a Creative Commons license. Read the original article.

