Can we stop Alzheimer’s before it starts? Dr. Domenico Pratico', MD, FCPP
- Dr. Domenico Pratico
- 2 days ago
- 4 min read
The research landscape of Alzheimer's disease has changed, the future is at hand. A future when early diagnosis is going to be a routine process. A time when we could know a decade or two in advance if an individual will develop Alzheimer's disease or other forms of dementia. A future when we can immediately and proactively intervene with therapies and other strategies targeting modifiable risk factors.
A future when an early diagnosis is not for “giving up” but for “acting on” and “fighting back”.
Alzheimer's disease, accounting for approximately 60-65% of all dementia cases, is a neurodegenerative disorder characterized among other things by the accumulation of amyloid beta plaques and tau tangles in the brain. The condition primarily affects memory, thinking, and behavior, gradually impairing an individual's ability to perform daily activities.
In its most common form, the sporadic or late onset, not a single cause has been identified so far. However, recent studies have clearly shown the existence of multiple factors that can influence the risk of developing the disease. Some of them are not modifiable like age, gender, and genes (i.e., APOE4), others, by contrast, are modifiable like dietary lifestyle, smoking, metabolic diseases.
In recent years, new discoveries and breakthroughs have informed us on some new important aspects of the pathophysiology of the disease.
Among them, todaty we now know that up to 45% of the cases of dementias (with Alzheimer’s being up to 65% of the total cases) could be delayed or prevented by simply correcting these modifiable risks factors.
Factors that affect a person's entire life, from before birth (in utero), education at a young age to cardiovascular health and socialization in later life, all of which when considered together are often referred to as the exposome or more precisely the “neuroexposome”.
This is the future of what we call precision or personalized prevention.
In fact, by implementing a simple blood test from now on we will be able to identify the presence of Alzheimer’s in a symptomatic individual or predict its later onset in a subject who does not have any symptoms yet. With this knowledge then start an appropriate strategy targeting the factors, pathways or elements that we know are active players for the onset and or the progression of the disease.
Importantly, all this information when combined with artificial intelligence technologies and methodologies will significantly increase our diagnostic power and allow us to intervene not only earlier and more precisely, but with a much higher chance of therapeutic success.
By looking at the current landscape in the Alzheimer’s field, here is a summary of what we have accomplished and where we are heading.
DIAGNOSIS. Best accuracy in the diagnostic process and result ever. The combination of established biomarkers with brain imaging is now making diagnosis increasingly accurate and consistent, reaching an unprecedent level of 98%.
POWER of PREDICTION. The ability to predict the time-course of the disease even before it starts from a clinical point of view in individuals with no symptoms. Again, a combination of biomarkers, with memory and behavior data can help forecast who will decline, providing a crucial window of opportunity for intervention.
PERSONALIZED TREATMENT and PREVENTION. Knowledge is power, and power gives a better chance to have control of a situation and obtain the best possible result from it. The early diagnosis and the ability to predict the onset will translate into a personalized treatment approach. We will be able to match the right patient at the right time with the right therapies and by doing so maximize results. This fact will also provide precision prevention. Having the ability to identify risk signals of risk factors long before symptoms emerge will allow a targeted early intervention which we can then monitor and adjust if necessary.
An early diagnosis is not for “giving up” but for “acting on” and “fighting back”.
I am sure that for some of my readers there are some aspects of the things I wrote about in this blog that might seem too “optimistic” or almost like science fiction, a dream or a faraway reality, but I can reassure you all that the things I described are happening in the now, and this is just the beginning!
Remember that all of us together, researchers, doctors, patients, caregivers and families are indeed building a future where not only Alzheimer’s can be stopped or slowed, but most importantly prevented before even the first sign manifests.
If you are interested in reading more of my blogs:
Check out my recent blog: The 4 Cardinal Points of Behavior Domenico Pratico', MD, FCPP
Domenico Praticò, MD, holds the Scott Richards North Star Charitable Foundation Chair for Alzheimer’s Research and serves as a Professor at the Alzheimer’s Center at Temple, as well as a Professor of Neural Sciences at Lewis Katz School of Medicine at Temple University.
For more information on the research conducted by Dr. Domenico Pratico, please visit this link.
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Stay updated with the work happening at Dr. Domenico Pratico's lab by visiting the Pratico Lab website.
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