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The next word that comes to mind is probably “memory”. Indeed, one of the most devastating effects of Alzheimer’s disease is the damage it causes to a person’s memory. However, brain changes occur as early as middle age, long before memory declines, in some cases decades before the diagnosis of dementia due to Alzheimer’s disease. Cognitive neuroscientists’ work on identifying these midlife changes points the way to new diagnostics and interventions, presented at the Cognitive Neuroscience Society (CNS) annual meeting in San Francisco this week. This view was put forward [1].
< /p>Society for Cognitive Neuroscience April 24th
University of California, San Diego Diego, UCSD’s William Kremen said, “The pathological process of Alzheimer’s disease begins decades earlier than dementia. The earlier we identify at-risk individuals, the better the opportunity to intervene to slow Disease progression.”
Professor William Kremen
Decline in executive function in midlife predicts risk of Alzheimer’s disease in later life, just one finding presented at a recent CNS Conference Symposium on Cognition and Brain Aging . Anja Soldan and Corinne Pettigrew of Johns Hopkins University (JHU) organized this workshop showing how to better understand how to distinguish between “normal” cognitive aging and disease-related Cognitive Aging Study.
Soldan said: “We now know that many age-related diseases, including Alzheimer’s disease and cerebrovascular disease, have a so-called preclinical stage, many years before the onset of clinical symptoms. This makes it difficult to say whether age-related cognitive changes reflect ‘normal’ age-related changes or changes associated with earlier disease. Understanding cognitive aging does require a life course method, but it is difficult to achieve.”
However, new digital health technologies and biomarker work, coupled with large-scale longitudinal More is being learned about brain changes early in life in Alzheimer’s disease and other neurodegenerative diseases.
Dr. Anja Soldan
Focus on executive functions strong>
Kremen first became interested in understanding the aging brain during a cognitive study of twins. “One afternoon, a few colleagues and I were brainstorming about the next steps in our research,” he recalls, “and we realized that if we studied this twin sample systematically over a long period of time, we might have a very interesting and valuable cognition and brain aging. I am now very interested in the huge growth in genetics research so that we can better understand the influence of genetic and environmental factors on normal and pathological cognition and brain aging strong>.”
In his latest work with Rongxiang Tang and Daniel Gustavson, Kremen attempts to connect cognition, the brain and genetics. They studied genetic data from 1,168 patients and 12 years of MRI data from 267 patients between the ages of 51 and 73, and found that executive function is the key to understanding age-related brain changes in Alzheimer’s patients. An important area of research.
“In Alzheimer’s disease, the focus is primarily on memory, but we want to highlight the fact that executive function is also important,” He explained, “Executive function is important to many aspects of daily life because it involves planning and anticipation, organization, being able to move appropriately from one task or topic to another, suppressing irrelevant thoughts or stimuli, so that people can focus on the task at hand.”
In unpublished research, Tang and colleagues identified a “modal controllability network” that is a link between midlife and late-life executive function changes Foundation. Kremen explained: “Modal controllability refers to the ability of brain regions to facilitate long-distance and effortful transitions into hard-to-reach states, an executive function. Changes in network controllability may be age-related .”
They also found that poor executive function was associated with a higher genetic risk of Alzheimer’s disease The score was related, which builds on previous work showing that poorer executive function is associated with an increased risk of developing mild cognitive impairment (MCI), which may be a precursor to Alzheimer’s disease. Taken together, Kremen said, this study and previous work suggest that “executive function in midlife is a predictor of Alzheimer’s disease progression.”
Kremen and his team want to continue studying the brain and genetic factors associated with Alzheimer’s disease. The goal is early identification, he said, and he believes the combination of genetics and cognitive research shows a promising path forward.
Identification of biomarkers for early detection
< p>Corinne Pettigrew became interested in the aging brain while studying stroke patients in graduate school. She is now working to understand cognitive changes and biomarkers in people at risk for Alzheimer’s disease and other cognitive impairments.
Dr. Corinne Pettigrew
presented at the CettiNS conference, strong>BIOCARD study, a longitudinal study from 1995 recruiting 350 mostly middle-aged adults. “Because this study is still ongoing, many of the generous volunteers have now been followed for over 20 years,” Pettigrew said. “Because of their dedication, we are in a relatively unique position to study midlife risk and Protective factors and how brain changes affect cognitive outcomes in later life, including cognitive impairment and dementia.”
The central findings of Pettigrew’s research so far For one, some of the underlying brain changes in Alzheimer’s disease begin in middle age. “Therefore, mid-life may be a very important time for intervention to delay or prevent future cognitive decline or symptoms of dementia,” she said.
For example, in a 2020 study published in Neurology [2], Pettigrew, Soldan and colleagues reported vascular Risk scores (for example, looking at factors such as high blood pressure, cholesterol levels, diabetes, and smoking) and biomarkers of beta-amyloid and tau (associated with Alzheimer’s disease) were associated with cognitive changes. They found that both vascular risk and Alzheimer’s disease biomarkers were independently associated with cognitive decline for approximately 14 years.
Research published on December 8, 2020 in the journal Neurology<(latest impact factor: 9.90)
Petigrew said: “Our biomarker findings suggest that Alzheimer’s disease-related brain changes are evident in middle age or earlier, especially in those Among those most likely to develop mild cognitive impairment (MCI) or dementia.” While there is currently no effective treatment for dementia, it is increasingly evident that Protecting the health of the brain and blood vessels, including maintaining cognition and physical activity, is critical to reducing the risk of cognitive decline, even for those with an increased genetic risk of dementia.
Soldan said, “I think this workshop is a good illustration of the fact that cognitive aging trajectories are influenced by many factors, and we can do some Things like physical activity and managing vascular risks like blood pressure and cholesterol to maintain a more positive trajectory.”
Soldan sees the exciting benefits of incorporating digital technology into brain and cognitive aging research An exciting future. “This includes all kinds of smart devices that people can wear at home that allow researchers to understand their sleep-wake cycle, physical activity levels, heart rate, blood pressure, etc.,” she said. Linked to brain and cognitive health. This may allow us to reach a wider and more diverse population.
She is also excited about advances in developing blood biomarkers for the treatment of Alzheimer’s disease and other diseases. “In the not-too-distant future, this may Let’s detect early Alzheimer’s disease during routine clinical examination, which may lead to the development of more effective interventions for cognitive decline. ”
Johns Hopkins University founded in 1876
References
Source: Cognitive Neuroscience Society
Moving beyond memory metrics for early identification of Alzheimer’s risk
References:
[1]. https ://www.cogneurosociety.org/symposium-sessions/#SYM5
[2]. Pettigrew C, Soldan A, Wang J, Wang MC, Arthur K, Moghekar A, Gottesman RF, Albert M. Association of midlife vascular risk and AD biomarkers with subsequent cognitive decline. Neurology. 2020 Dec 8;95(23):e3093-e3103. doi: 10.1212/WNL.000000 0000010946. Epub 2020 Sep 28. PMID: 32989109; PMCID: PMC7734925.
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