At his laboratory at Washington University in St. Louis (WUSL), Dr. Ances focuses on developing non-invasive procedures for identifying brain changes and biomarkers related to the disease to make diagnoses earlier, when interventions may be more successful.
“If you don’t know someone who has Alzheimer’s disease… then you are very unusual because really this disease is affecting everybody that we know and affects us all in some way,” he said. “The good news is that there are a lot of new biomarkers that are being developed, meaning ways that we can analyze what’s happening in the brain in a living individual.”
Dr. Ances discussed these new methods, including blood and spinal fluid processes, in a virtual talk with Calvert alumni
late last month, stressing that early detection is key for impactful intervention.
According to the Alzheimer’s Association, the disease is thought to begin 20 years or more before noticeable symptoms, like behavioral changes and memory loss, reveal themselves. While some memory loss is part of “normal” aging, significant departures from someone’s baseline abilities and habits can suggest an issue.
One in three seniors dies with Alzheimer’s or another dementia, and definitive diagnoses are usually made after patients have already passed away.
“If we are to think of Alzheimer’s disease in and of itself, we are really facing a silver tsunami,” Dr. Ances said. “It’s the sixth-leading cause of death in the United States, and it’s the only one where we have no cure or significant treatments.”
Now, though, Dr. Ances and his team are investigating new diagnosis methods that can be used while patients are still alive. He outlined a few of these non-invasive procedures during his discussion with alumni.
Positron Emission Tomography (PET) imaging involves injecting patients with radioisotopes specific to amyloid plaque or tau protein, two hallmarks of Alzheimer’s disease, to see if those materials significantly increase over time. If they do, neurologists can diagnose the disease.
“What has really changed the field is we can make that in vivo, so we don’t have to wait for the person to pass away. We can make in vivo diagnosis of an individual while using a simple technique,” Dr. Ances said.
Doctors can also use a lumbar puncture (or spinal tap) to retrieve fluid surrounding the brain and spinal cord. By analyzing this fluid, Dr. Ances and his colleagues can measure amyloid and tau levels in the brain, enabling them to make a sensitive diagnosis.
According to Dr. Ances, blood biomarkers represent the next great step in diagnosing Alzheimer’s disease, and he expects this measure to become more available in the near future.
“I’m going to tell you that in the next five years, this is the way we are going to be making a diagnosis. It’s going to be revolutionary,” Dr. Ances said. “What we’re doing is, instead of looking at the spinal fluid, we can measure that same active amounts of amyloid and tau but in the blood.”
During his discussion with alumni, Dr. Ances stressed that early diagnoses will allow patients and their caregivers to address symptoms more readily, lessen the anxiety of an unknown condition, refine care for co-morbidities, and feel more confident making long-term decisions on care, finances, and living arrangements.
Despite these advances, though, further research is needed to identify interventions that effectively fight Alzheimer’s disease.