By Danette Taylor, MD
Henry Ford Hospital, West Bloomfield, Michigan
Alzheimer's disease is a common disorder that produces a lot of concern for patients. "Do I have Alzheimer's?" is the question that neurologists hear from almost every patient with memory problems. It's also a question that researchers are trying to help answer.
A recent study suggests that the risk of developing Alzheimer's disease can be predicted long before symptoms are seen. Individuals who show loss of volume or brain size in certain areas are more likely to develop changes in their ability to think and reason, consistent with the changes seen in early Alzheimer's disease.
The researchers looked at images of the brains of 159 persons. The images were used to divide the participants into three groups—those with brain atrophy (shrinkage) rated as above average, those with atrophy rated as average, and those with brain atrophy rated as below average. Each group was followed for at least three years and then re-evaluated.
The group that showed the highest rate of atrophy also had the highest number of people who developed findings consistent with Alzheimer's disease, about 21%. Only 7% of the group with average amounts of atrophy showed similar changes, while no one in the group with the least amount of shrinkage developed memory loss.
This is an important finding since the medications available today can only help slow the progression of memory loss rather than restore lost function. If we can use imaging studies as a tool to identify patients at risk, we may ultimately be able to use the same studies to identify those patients who are candidates for early treatment—and potentially avoid the forgetfulness and cognitive decline once thought to be an inevitable part of aging.
While researchers debate the significance of how much shrinkage is important, one take-home message might be that doing as much as possible to prevent brain shrinkage will be of benefit. Information about dietary strategies, physical exercise, and even brain games—all of which may play a role in protecting brain cells and volume—is widely available.