MOSCOW, February 27, Tatyana Pichugina Scientists from China have discovered biomarkers that can predict dementia in ten years. This will help doctors. When the discovery will be implemented and how diagnostics are carried out now — in the material .
Predict dementia
A 70-year-old woman is admitted to the hospital for examination. Over the past four years, her family has noticed strange things about her. She quickly forgets what the conversation was about, loses things, and suspects family members of theft. Does not remember his own plans — for example, making an appointment with a doctor. May get lost on a well-known route. Confused by memories. At the same time, she herself is not aware of the problems.
These are symptoms of Alzheimer's disease, which usually occurs in people over 65 years of age and gradually leads to personality disintegration. The population in developed countries is aging, which means there are more and more such patients. After 90 years — every fifth. The burden on the healthcare system is increasing, and families who have to organize care for relatives are suffering.
The disease is incurable, but there are medications that slow its progression. It is important to get diagnosed as early as possible to delay dementia. The problem is that sometimes many years pass before the first symptoms appear, and by the time a person seeks help, too many neurons have already died in the brain.
Memory and intelligence are also lost for other reasons: injuries, cerebral circulatory failure, various pathologies, such as dementia with Lewy bodies. But Alzheimer's disease accounts for up to 60 percent of such cases.
Scientists from time to time identify certain biomarkers of dementia. It is now clear that there is no single molecule associated with pathology. It is necessary to consider several signs by which screening is possible. Proteomics, the study of the totality of proteins in tissues, helps with this.
Scientists from Fudan University in China analyzed data on 1,463 proteins in the blood plasma of more than 52 thousand people from the UK Biobank . There were no people suffering from dementia among the study participants (2006-2010). Over the next 14 years, 1,417 people became ill.
On average, the pathology manifested itself at the age of 66 years. 691 people have Alzheimer's disease.
Scientists have identified many proteins associated with dementia of all types and Alzheimer's disease. The best predictors of pathology were GFAP, NEFL, GDF15, and LTBP2. Moreover, individually, these biomarkers are not so informative.
For example, GFAP, or gliofibrillary acidic protein, is concentrated in the glial cells of the brain and almost does not enter the bloodstream of a healthy person. If it is detected, it means that something is wrong with the nervous system. It was found that its high concentration in the blood more than doubles the risk of dementia. Together with the NEFL protein (thin polypeptide neurofilament), it indicates the disease even more accurately.
However, biomarkers alone are not enough, the authors of the work note. Dementia is a multifactorial disease with a variety of symptoms.
Early warning signs: what to look for
“To diagnose Alzheimer’s disease, cerebrospinal fluid is examined. As for blood biomarkers, there is no reliable method yet,” says Vladimir Zakharov, Doctor of Medical Sciences, Professor of the Department of Nervous Diseases and Neurosurgery of the First Moscow State Medical University named after I.M. Sechenov. Cognitive diseases are not diagnosed anywhere by blood, although this is theoretically possible, he adds.
The first symptom of Alzheimer's is increased forgetfulness, when a person says the same thing, repeats a question, or buys something in a store that he has already bought. With vascular dementia, first of all, it is difficult to concentrate, rapid fatigue sets in during mental work, and fog in the head.
“It all starts quite harmlessly,” the professor notes. It seems that the intellect is preserved, the person is independent, works. Not everyone will see a doctor because of forgetfulness. Meanwhile, the disease progresses, the brain loses nerve cells every day.
At some point, the disease literally sets in, the personality disintegrates before our eyes, and dementia sets in. That is why more attention is now being paid to the so-called moderate cognitive impairment.
“This is an intermediate state between the norm and obvious pathology, when the first symptoms are already present, but the person still maintains independence and autonomy and does not need outside help,” explains the doctor. .
At this stage, the doctor is not yet sure of the diagnosis; the disease can develop in different ways. However, it already needs to be treated.
“The progression of pathology is slowed down, for example, by drugs combining melatonin and memantine. They affect the universal mechanisms of brain damage, such as neuroinflammation,” the specialist points out.
At the same time, it is important lead a healthy lifestyle, give up bad habits, maintain regular mental and physical activity, since, in addition to genetic predisposition, high blood pressure, high cholesterol, and diabetes mellitus contribute to dementia. Risk factors include injuries, low levels of education and intellectual activity.
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