September is World Alzheimer’s Month, and in recognition, it’s a good time to take stock of where things stand. In general, we continue to face a world where there are few effective treatments (and lots of continued controversy about Aduhelm, the recently FDA-approved treatment for Alzheimer’s, which many insurers and medical facilities are now rejecting), and a growing population of Alzheimer’s patients. About 70% of diagnosed dementia cases are thought to be caused by Alzheimer’s and in fact, 1 out of 9 people over age 65 has some form of Alzheimer’s at this moment. Previously in agebuzz, we discussed the philanthropic efforts in support of Alzheimer’s research from Bill Gates, who started his work in Alzheimer’s after his father was diagnosed. Recently, Gates discussed his optimism regarding the pace and focus of research in the field, with particular attention to innovative and accessible ways to diagnose Alzheimer’s in its earliest stages, which may be our best hope for treating patients before too much brain destruction has occurred. As Gates wrote, “If we want to stop Alzheimer’s, one of the biggest things we need to develop is a reliable, affordable and accessible diagnostic.” In recent weeks, several new potential diagnostic tools have been described in the research literature.

For example, utilizing cutting-edge deep learning technology, researchers in Lithuania appear to have developed an algorithm that spots early signs of Alzheimer’s with almost 100% accuracy. By looking at the brains of those with mild cognitive impairment (which sometimes, but not always, progresses to dementia), the algorithm was able to discern which patients would go on to develop Alzheimer’s. While the study was too small to have current clinical application, it bodes well for efforts to diagnose Alzheimer’s at a point early enough to potentially intervene to slow or stop brain deterioration. Another recent study out of Washington University in St. Louis used an algorithm to detect when a person without current symptoms may reach a tipping point at which time they will be on a reliable trajectory toward Alzheimer’s. Published in the journal Neurology, this research used data from just one PET Scan, in combination with the patient’s age, to not only detect who is at higher risk but actually when symptoms may begin to appear. Also not yet ready for clinical use, this research may nonetheless help identify patients who may be able to enter clinical trials early enough to receive meaningful benefits from new drugs. For more on this research, click here.

Using current technologies, there are scientific advances in diagnosing Alzheimer’s that may be ready for clinical use in the near future. For example, researchers at the University of Bath report the development of a 2-minute “passive test” called the “Fastball EEG” which measures brain waves while the patient is watching a series of flashing images. This is a technology that is readily available in most medical settings and does not require active participation from the patient (thereby making it accessible for patients who cannot respond to a series of memory questions). As the researchers state, “Ultimately the Holy Grail of a tool like this would be a dementia screening tool used in middle age for everyone, regardless of symptoms, in the same way we test for high blood pressure. We are a long way from that, but this is a step towards that goal.” To learn more about this exciting development, read here.

Finally, recognizing the eyes are a window to the soul, a new test examining a patient’s retina for signs of the same amyloid plaque seen in the brains of Alzheimer’s patients appears to be on the horizon. The research for this new diagnostic test comes from UC San Diego and is published in the journal Alzheimer’s and Dementia. It seems that these amyloid plaques, which collect between the brain cells of Alzheimer’s patients and eventually lead to cell deaths, also occur in a patient’s retina, so that retinal imaging to discern the presence of amyloid may be a useful way to detect a risk of Alzheimer’s at an early stage. A larger study is needed to determine if this is a viable diagnostic test, but it’s one more example of finding inexpensive, readily accessible technology to screen for Alzheimer’s early enough in the trajectory to make a meaningful difference. For more about this study, focus your eyes here.