5 minute test that warns of dementia — years before symptoms start

There’s still no cure, so would YOU be brave enough to try the new . . .

Developing A lzheimer’s or another form ofd ementia i s m any B ritons’ worst f ear w hen i t c omes to ageing, according to a recent survey by Yougov. And it’s easy to see why. outside the pandemic years, when Covid deaths slightly outnumbered dementia deaths (by 0.6 p er cent), dementia and A lzheimer’s disease have been the leading c ause o f m ortality i n t he U K. i n care homes it’s to blame for more than 65 p er cent of deaths, data from the office for national Statistics show.

Butwouldyouwanttoknow,morethan a d ecade i n a dvance, t hat d ementia was to be your fate?

How would that devastating news change your life, especially when there may be little you can do to delay its onset and science has repeatedly failed to c ome u p w ith d rugs t o c ure — o r e ven radically slow — its progress?

These d ifficult q uestions a re n o l onger just hypothetical.

in Britain, a University of Cambridge spin-offcompany,calledCognetivityneurosciences, is beginning nHS trials of a simple, five-minute diagnostic test that, the firm claims, will instantly and accurately predict your risk of A lzheimer’s in up to 15 years’ time.

The timing of this is significant as B ritain f aces a n e pidemic o f A lzheimer’s disease and dementia owing to its ageing population. The numbers affected are forecast to jump from

around 8 00,000 t o m ore t han 1 .2 m illion in england and Wales by 2040.

Yet most people are only diagnosed once symptoms — such as severe m emory loss, confusion, forgetting words or becoming anxious and w ithdrawn — start to appear.

Thenewtestisremarkablysimple,says J ames M edcalf, c ommercial d irector of Cognetivity neurosciences.

‘in the test you are shown quickly — only for about 100 milliseconds — p ictures that feature either an animal or no animal. You are asked to respond

quickly by pressing “yes” or “no”, depending on whether you see an animal,’ he says.

‘in evolutionary terms, spotting an animal very quickly was vital for our survival. The task involves some o f t he m ost b asic s tructures of our brains, such as the a mygdala, w hich h elps t o r egulate our fight-or-flight responses.’

AS THe test relies purely on i nstinctive r esponses, we don’t consciously learn how to perform it, so practice cannot improve a p erson’s scores over time.

But why is this reactionimportant in terms of predicting dementia risk?

‘in the earliest stages of A lzheimer’s, i t i s n ot m emory t hat gets affected,’ says Mr Medcalf.

‘Research shows instead that it is your brain’s processing speed that starts to slow, and this is what the new test shows.’

it is designed to work on screenssuchasanAppleipad.The company says the test is so straightforward that it plans to sellanabbreviatedtwo-minuteform to anyone who wants to use it at home.

‘You could use it every day, to track how you’re doing over the weeks,’ adds Mr Medcalf.

pilot projects are under way at three n HS t rusts, i n S taffordshire, SussexandtheWestMidlands,and t wo c are h omes, t o t ry t o p ick

up signs of mild cognitive impairment (MCi), where people start forgetting names, have t rouble planning or organising things or get easily distracted.

An estimated one in ten people with MCi develops dementia. Meanwhile, scientists at the

C entre for neurodegenerative D iseases in Bonn, germany, are working o n a r ather m ore c omplex test t hey b elieve w ill a lso p redict i f someone will get dementia up to five years before it develops.

They have identified three molecules in the blood, called microRnAs, that may indicate Alzheimer’s risk. MicroRnAs act as chemical messengers between cells, transporting instructions about, f or e xample, t he b uilding o f essential new proteins.

in research published inthe journal eMBo Molecular Medicine, t he s cientists d escribed how 90 p er cent of older people with v ery r aised l evels o f t he t hree molecules developed Alzheimer’s within two years.

Andre Fischer, a professor of psychiatry who led the research, says: ‘An increased blood level of these three microRnAs can indicate that Alzheimer’ss ymptoms w ill b egin a bout t wo t o

five years later.’ Researchers now hope to develop a simple blood test that can be applied in routine medical care to assess d ementia r isk.

They say it may also bepossible todevelop drugsthat can reverse the increase in thesemicroRnAs

— potentially undoing some of the damage.

But how helpful is it to find out years in advance that you may be on course for an incurable i llness?

Hannah Churchill, research c ommunications manager at the Alzheimer’s Society, told good Health: ‘There is no sure-fire way to prevent the onset of dementia. Researchers believe that only around 40 p er cent of cases may

be p reventable, b y a ddressing r isk factors such as hearing loss, s moking, excess drinking or o besity. The other 60 per cent of dementia c ases m ay n ot b e l inked to m odifiable r isk f actors. o ur a ge and genetics will also play a role and are outside our control.’

But not everyone thinks this renders risk-testing useless. ‘There has always been this argument in dementia care: should w e b other d oing s omething if we can’t do anything about it?’

says Mr Medcalf. ‘i say yes — at the very least you can put your affairs i n o rder a nd g ive l egal p ower

of attorney to your loved ones in good time.’

However, research suggests p eople prefer not to know their risk of dementia.

The Social Care institute for excellence, a UK charity, says

many people with early signs of dementia‘choosenottoseekadiagnosis’ because of concerns about the effect on their jobs, social lives and ability to drive.

in May 2020, psychiatrists at Yale U niversity i n t he U .S. r eported that adults aged over 65 who had recently been diagnosed with A lzheimer’s or other types of dementia were twice as likely to die from suicide compared with those who didn’t have dementia.

Authors of the study, published in the journal Alzheimer’s &

Dementia, s aid a ll p atients s hould be g iven ‘ suicide r isk s creening a nd additional support at the time of receiving a dementia diagnosis’.

THe Alzheimer’s Society agreesthatpatientsandloved ones should receive this support, including, says Hannah Churchill, access to peer support groups, education for carers and care planning.

it could also mean starting m edicines that might help the p erson cope with their symptoms — such as Aricept, a drug which helps nerve cells damaged by dementia to keep communicating with each other.

it can temporarily ease some symptoms b ut c annot p revent t he disease from worsening.

‘For many, a dementia diagnosis may be a relief — an explanation

for the changes they’ve been e xperiencing, especially if they have lived with symptoms for years,’ says Hannah Churchill.

‘And early diagnosis means b etter a ccess t o p ersonalised c are and s upport, s uch a s o ccupational therapy, w hich m eans p eople w ith dementia can live well for longer.’

So is there any prospect of a drug that could stop Alzheimer’s in its tracks?

Scientists a t D urham U niversity last week revealed they had d eveloped a futuristic £7,000 h elmet that might be able to reverse dementia by zapping the brain with pulses of infrared light to boost memory and processing skills.

But the technology is several years away from routine use.

Hopes of a breakthrough in the search for a pharmaceutical s olution were raised earlier this year by the fast-track approval in the U.S. of aducanumab, a drug that c ould s low o r h alt A lzheimer’s by reducing the build-up of a toxic protein — called amyloid — in the brain.

But the approval caused huge controversy, with some critics accusing the U.S. Food and Drug Administration — which gave it the green light — of ignoring the unanimous verdict by its expert advisory committee that trial e vidence failed to show that a ducanumab is effective.

The i njectable d rug, w hich c osts £42,000 p er p atient p er y ear, i s n ot available here. But UK regulators are c arrying o ut t heir o wn r igorous assessment to see if the clinical benefits justify a licence.

The drug would then have to be evaluated for cost benefit by the national institute for Health and Care excellence.

According to the charityA lzheimer’s Research UK,that process is unlikely to be c ompleted until ‘the middle of 2022 at the earliest’.