Mayo Clinic scientists have developed a new method to predict Alzheimer’s risk decades before symptoms arise, using brain scans and genetics to estimate a 10-year likelihood. This breakthrough could revolutionize the way the disease is detected and managed, potentially leading to earlier interventions and improved outcomes for patients.
The research, published in The Lancet Neurology, is based on decades of data from the Mayo Clinic Study of Aging, which has tracked thousands of residents over time. Led by Dr. Clifford Jack Jr., a radiologist at Mayo Clinic in Rochester, Minnesota, the team analyzed brain scans, genetics, and medical records from more than 5,800 adults to build a model that predicts both a person’s 10-year and lifetime risk of developing cognitive decline.
Two key proteins, amyloid and tau, begin to build up in the brain long before symptoms of Alzheimer’s appear. These proteins disrupt communication between neurons and eventually lead to memory loss and cognitive problems. Using specialized imaging techniques, the researchers were able to measure amyloid buildup to assess the ‘biological severity’ of Alzheimer’s in cognitively healthy individuals.
The findings were presented on a scale from 0 to 100, where a low score indicates minimal amyloid buildup and a high score signifies significant accumulation. This risk estimate could help individuals and their doctors decide when to start therapy or make lifestyle changes that may delay the onset of symptoms, similar to how cholesterol levels predict heart attack risk.
The scientists also factored in age, sex, and the presence of the APOE ε4 gene, a genetic variant linked to increased Alzheimer’s risk. They used advanced statistical techniques to project the likelihood of developing mild cognitive impairment and dementia over time. However, the study has limitations, including its focus on older white adults from a single region and the use of expensive brain scans that are not widely accessible.
Future iterations of the tool may include blood tests for amyloid or other biomarkers, making risk assessment more accessible without the need for specialized scans. The study was funded by the National Institute on Aging, the GHR Foundation, Gates Ventures, and the Alexander Family Foundation.