Morris: Study's senior author
By Gila Reckess
March 2, 2001
School of Medicine researchers have new evidence that Alzheimer's disease begins to affect the brain even before a person experiences the memory loss and other cognitive impairments that accompany the disorder.
Morris: Study's senior author |
The research, presented in the Feb. 13 issue of the journal Neurology, suggests that efforts to develop vaccines and targeted therapies need to be redirected toward preclinical signs of brain deterioration.
"To develop a treatment that will prevent dementia, we apparently need to find ways to identify the appearance of Alzheimer's disease lesions before clinical symptoms arise," said John C. Morris, M.D., the Harvey A. and Dorismae Hacker Friedman Professor of Neurology and co-director of the medical school's Alzheimer's Disease Research Center (ADRC). Morris also is on the medical staff of Barnes-Jewish Hospital.
Alzheimer's disease affects an estimated 4 million Americans.
Researchers at the ADRC identified 24 people who died when they were at least 75 years old and had been assessed by psychometric tests within two years before death. At their final assessment, 10 of these individuals were diagnosed with very mild dementia of the Alzheimer type, whereas the other 14 showed no signs of cognitive decline.
Post-mortem examinations revealed that five of those who had no cognitive impairment had plaques and brain deterioration typical of Alzheimer's. Their psychometric assessment results were the same as those who had no Alzheimer's disease neuropathology, and their cognitive performance had not declined over the years. In contrast, patients diagnosed with very mild dementia before death had performed progressively worse on the annual psychometric evaluations.
"These findings suggest that a person beginning to develop Alzheimer's disease might not have any cognitive signs of the disease," said Morris, who led the study. William P. Goldman, Ph.D., a former neurology fellow now at the University of California at San Francisco, was first author of the paper.
The authors call the incubation period a preclinical phase and recommend that the current view of Alzheimer's disease development and progression be revamped.
Morris believes the study, taken in the context of previous findings, fails to support the notion that everyone who lives long enough becomes senile.
"Our work suggests that aging itself is an entity distinct from Alzheimer's disease," he said. "The data imply that cognitive abilities in normal aging by and large remain intact as long as AD and other dementing illnesses are absent."
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