7.1.3 – Difficulties of Early Diagnosis of Alzheimer’s Disease

From the previous section, we know that the risk factors and the causes of Alzheimer’s Disease are very wide spanning from the genetic predispositions of an individual to its lifestyle and through its interactions with the surrounding environment. Besides that, most of the molecules and bio-markers found in the hallmarks of AD are relatively new and their functions are still vague. ApoE, for example, has a very wide array of functions reflecting the complex mechanisms that the cells must have undergone to affect the production of amyloid plaques, tangles, oxidative properties and tau proteins. The uncertainty in pinpointing the early causal factor of AD made it difficult to focus on the initial symptoms that may happen in the prodromal stage.

In addition, even though the rate of symptoms occurring in AD individuals is significantly different from otherwise healthy individuals, there has yet to be an established average or threshold for the rate of plaque build up over time for comparisons. This means that there is no baseline that can be referred to in measuring the risk of individuals to develop AD. A study reported that it takes approximately 20-30 years for the plaques and tangles to build up before showing its first symptoms. Since the symptoms are relatively generic and can happen to healthy individuals, a diagnosis can only be confirmed after patients have suffered from progressive and severe damage to  neuronal cells and when their behavioural symptoms have already appeared. This in turn, only allows tests to be made on people who are already diagnosed with AD instead of the people showing early signs.

There are also studies that collected cerebrospinal fluid (CSF) from patients suffering from cognitive problems to investigate bio-markers that can be used to diagnose AD without a biopsy. However, this only allows differentiation between individuals suffering from cognitive problems due to AD and individuals suffering from cognitive problems due to other health issues. There have yet to be any bio-markers that are definitively associated with the early stages of AD.

Conclusively it is important to diagnose this disease as early as possible to prevent the symptoms from further affecting  brain function. Since AD is also impacted by lifestyle and environment, individuals with a high risk of developing AD will have a higher probability of slowing down or preventing AD progression by altering their lifestyle and managing their environmental exposure to risk factors instead of depending on medications to affect their gene expression. It is almost impossible to change an individual’s genetic structure, but it is possible to alter their lifestyle to reduce risk. Since a healthy diet and active lifestyle are also implicated in reducing the risk of many other diseases, managing these risk factors can consequently increase an individual’s life expectancy as well as their quality of life.

Discussion

Since it is difficult to diagnose AD in the early stage, our route to preventing AD is limited to the current information that we have right now. New discoveries take a long time before any intervention can be made based on them. While waiting for new development or discovery of new treatments for Alzheimer’s disease, what can we currently do as public citizens in curbing Alzheimer’s Disease from a community level?

 

License

Selected Topics in Health and Disease (2019 Edition) Copyright © by Dr. Ju. All Rights Reserved.

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