A team of Mayo Clinic scientists have created a way to estimate a person’s risk of developing memory and thinking problems long before symptoms of Alzheimer’s disease begin, potentially changing how the disease is detected and treated in the future.
The research, published in The Lancet Neurology, draws on decades of data from the Mayo Clinic Study of Aging, a long-running effort that tracks thousands of residents over time, according to a press release.
Led by Dr. Clifford Jack Jr., a radiologist at Mayo Clinic in Rochester, Minnesota, the team analyzed brain scans, genetics and medical records from more than 5,800 adults to build a model that predicts both a person’s 10-year and lifetime risk of developing cognitive decline.
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Long before forgetfulness or confusion appear, two key proteins called amyloid and tau start building up in the brain. Amyloid forms sticky plaques, while tau forms tangles inside brain cells.
Together, they disrupt communication between neurons and eventually cause the memory loss and cognitive problems that are the hallmarks of Alzheimer’s, according to multiple sources.
Using specialized brain imaging that measures amyloid buildup, the researchers were able to gauge the "biological severity" of Alzheimer’s in people who were still cognitively healthy.
The results were expressed on a scale from 0 to 100. A low number means little to no amyloid; a high number signals significant buildup.
"This kind of risk estimate could eventually help people and their doctors decide when to begin therapy or make lifestyle changes that may delay the onset of symptoms," study co-author Ronald Petersen, M.D., Ph.D., neurologist and director of the Mayo Clinic Study of Aging, said in the press release.
"It's similar to how cholesterol levels help predict heart attack risk."
The scientists factored in age, sex and whether participants carried the APOE ε4 gene, a genetic variant known to raise Alzheimer’s risk.
They also used a powerful statistical technique to project how likely each person was to develop mild cognitive impairment (MCI) and then dementia over time.
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Researchers found that the higher amyloid levels were in the brain, the greater the lifetime and 10-year risk of developing memory problems.
One 75-year-old woman in the study who carried the genetic variant and had high amyloid buildup faced more than an 80% lifetime risk of developing MCI — a transitional stage between normal aging and dementia that can still allow for independent living.
Women overall had a higher lifetime risk than men, and those with the gene were more likely to experience cognitive decline than those without it.
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The study has some limitations, the researchers acknowledged.
It mostly involved older white adults from one area, so the results may not apply to everyone. It also used expensive brain scans that most people don’t have access to, and it didn’t factor in lifestyle or health habits that can affect memory.
For now, the new tool is used only for research, but Mayo Clinic scientists say it’s an important step toward personalized Alzheimer’s prevention.
Future versions may include simple blood tests for amyloid or other biomarkers, making it easier to assess risk without specialized brain scans.
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The study was funded by the National Institute on Aging, the GHR Foundation, Gates Ventures and the Alexander Family Foundation.
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