Alzheimer’s disease, the most common cause of dementia, is increasingly understood as a condition that begins to develop years, even decades, before noticeable cognitive decline. Recent research focuses on identifying biomarkers – measurable indicators of disease – to enable earlier diagnosis and, potentially, more effective treatment interventions. This was discussed during a seminar on medicine and health held on , as reported by the Gaceta Médica de la UNAM.
Currently, diagnosis of Alzheimer’s relies heavily on documenting cognitive impairment, a point at which significant and often irreversible brain damage has already occurred. Researchers are striving to shift this paradigm by detecting the disease in its earliest stages, before symptoms manifest. The hope is that future treatments will be most effective when targeted at the disease process before substantial neurological harm takes place.
The Role of Biomarkers
Biomarkers offer a promising path toward earlier detection. These biological markers can be measured to indicate the presence of disease. Examples of established biomarkers for other conditions, such as blood glucose levels for diabetes, illustrate the principle. In the case of Alzheimer’s, researchers are investigating several potential biomarkers, including levels of beta-amyloid and tau proteins in cerebrospinal fluid (CSF) and changes detectable through brain imaging, also known as neuroimaging.
Dr. Erwin Chiquete Anaya, a researcher at the National Institute of Medical Sciences and Nutrition “Salvador Subírán,” explained that Alzheimer’s disease is characterized by a toxic accumulation of beta-amyloid and tau proteins. These proteins degrade parts of the brain crucial for basic functions like memory and cognitive processes. The buildup of these proteins ultimately leads to the state of dementia.
The process of validating a biomarker is rigorous. Multiple studies, conducted in large and diverse populations, are necessary to establish that a biomarker accurately and reliably indicates the presence of the disease. The laboratory methods used to measure the biomarker must be consistently stable and reliable.
Diagnostic Factors and Global Variations
According to Dr. Chiquete Anaya, a diagnosis of Alzheimer’s disease requires verification of three key factors: the presence of beta-amyloid, tau and evidence of neuronal damage. These are assessed through neuroimaging techniques like magnetic resonance imaging (MRI), as well as analysis of biomarkers in cerebrospinal fluid (CSF) and blood plasma.
The availability and implementation of these diagnostic tools vary globally. Not all laboratories have access to the necessary reagents to perform a comprehensive biomarker analysis. Precision in diagnosis is particularly critical when the disease is in its early stages.
Beyond Biology: Genetic and Lifestyle Factors
While biological factors are central to Alzheimer’s development, other factors also play a role. Genetic predisposition, such as in individuals with Down syndrome, can increase risk. The quality of education received during early life appears to be protective, with good brain development potentially lowering the probability of developing the disease.
A Multifactorial Disease and the Importance of Collaboration
Dr. Chiquete Anaya emphasized that Alzheimer’s disease is multifactorial in over 90% of cases, with genetic factors accounting for the remaining 10%. Dementia, he noted, is typically a late manifestation of the underlying disease process. Current treatment strategies are tailored to the stage of Alzheimer’s, encompassing both cognitive enhancers and, increasingly, anti-amyloid biological therapies.
Dr. José Nicolás I. Martínez López, a psychiatrist and researcher, highlighted the importance of collaboration between neurology and psychiatry in the care of patients with cognitive impairment. He suggested that a combined approach, incorporating lifestyle changes and improved education, could even contribute to prevention.
The Future of Alzheimer’s Diagnosis
Looking ahead, Dr. Chiquete Anaya acknowledged the potential value of technological advancements in Alzheimer’s diagnosis and monitoring. However, he cautioned against replacing human functions that strengthen brain health. He also recognized that, despite progress in identifying biological and technological indicators, some aspects of the patient experience, such as overall happiness, remain difficult to quantify.
The ongoing research into biomarkers represents a significant step forward in the fight against Alzheimer’s disease. By enabling earlier and more accurate diagnosis, these tools hold the promise of improving treatment outcomes and ultimately alleviating the burden of this devastating condition.
