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Body clock disruptions may indicate early-stage Alzheimer's

Dementia symptoms Alzheimers risk treatment sleep

That's what makes a study published (paywall) today (Jan. 31) in the journal Nature so exciting: scientists working in Japan and Australia announced they've identified certain fragments of proteins, that, when found in the blood, mean amyloid proteins are building up in the brain.

It's always been a conundrum for Alzheimer's researchers: without an low-cost way to diagnose the disease, it's been hard to study and develop drugs to treat it, but there won't be a market for a diagnostic test until someone develops a drug that can improve patients' lives. Most have normal sleep/wake cycles, and body clock disruptions are associated with old age, sleep apnea, and other causes.

Senior study author Katsuhiko Yanagisawa, director general of the National Center for Geriatrics and Gerontology in Japan, is convinced that enough amyloid penetrates the blood-brain barrier to make its way into the bloodstream to be a useful measure of cognitive function.

While up to 40 per cent of Australians over 70 are considered at risk of Alzheimer's, pharmaceuticals have barley put a dent in tackling the root causes of the disease. Preclinical studies have shown that the accumulation of both amyloid beta and oligomeric amyloid beta, the small aggregates of amyloid protein commonly found in the brain with Alzheimer's disease, were toxic to mitochondria. "We hope our method accelerate clinical trials of those candidates".

They then checked the accuracy of their predictions using the accepted PET scan and spinal fluid measurements, and found that the test was right nine times out of 10.

However, this test could allow patients to be prioritised for further testing, or as candidates for trials of new drugs, they said. Scaling up trial numbers should also help trials more accurately represent the actual population. "It is from a top research team". And most important, they are correlating their results to PET and CSF.

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"I don't know that this one is it", she said in an interview, "but I am convinced that over the next few years, we'll have a blood test that substantially improves our ability to detect amyloid before people have symptoms".

Emory University neurologist William Hu, who also did not participate in the study, agrees.

Hu also points out the overall levels of amyloid differed between the Japanese and Australian groups.

Among the remaining 50 involved in the study, with either brain scans or cerebrospinal fluid indicating an abnormality, all experienced significant disruptions in their internal body clocks, determined by amount of rest achieved and activity during the day. Hers are relatively low-priced at about $2,500 each, she said; a patient who wanted one might have to pay as much as $5,000, and not all insurance companies will cover the cost, because there are no better treatments to offer people whose disease is confirmed.

There's still a long way to go before this kind of test can be used in a clinical setting. Multiple authors on the paper have even filed for patents for the technique.

Fragmented sleep, marked by repeated wake-ups during the night and a need to nap during the day, could be an early sign of Alzheimer's disease, according to new research. "But still, at this point it is not ready for prime time".

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