In Alzheimer’s disease, protein pieces called beta-amyloid begin to clump together and build into plaques. Over time, they collect between neurons, disrupting cell function. Before known symptoms even begin, these plaques start forming in areas of the brain related to learning, memory, and planning. Being able to detect these brain changes before the symptoms become apparent may help with early treatment, though it’s currently difficult to do so. New research may have found an avenue that helps.
Researchers at Mass General Brigham recently tested a daily learning assessment to see if it could help detect Alzheimer’s-related brain changes in the preclinical stage. The goal was to see if it was a more effective evaluation than tests taken at a single point in time. According to findings published in the journal Annals of Neurology, patients with elevated beta-amyloid performed progressively worse over seven days on the smartphone-based daily learning assessment, when there wasn’t much of a score difference between the two groups at the beginning. This could provide a new option for detecting the earliest cognitive changes in preclinical Alzheimer’s, which could ultimately mean better outcomes for patients.
Dr. Kathryn Papp, study co-author from the Department of Neurology at Brigham and Women’s Hospital, explains, “This gives us some insight into the type of memory that declines at the earliest stages of disease. The findings could have a direct benefit on improving the way we measure treatment effects in clinical trials and how we will monitor risk for cognitive decline in a large, aging population in the future.”
The test in question includes three tasks: The Digit Sign Test, which shows participants six street signs with digits and then asks them to identify the correct pairing of the digits and signs; the groceries test, which has participants remember the price of a grocery item; and FNAME, which involves remembering a series of face-name pairs.
The assessment – called the Multi-Day Boston Remote Assessment for Neurocognitive Health (BRANCH) test – was taken for 12 minutes a day, seven days in a row on a personal device. The participants included 36 patients with elevated amyloid and 128 that were amyloid-negative. They were all between the ages of 60 and 91.
The group also underwent standard in-clinic paper cognitive tests. Within a year, researchers followed up with 123 participants.
The team found that those who had a diminished learning curve over seven days were more apt to have amyloid in their brains and also had a higher risk of cognitive decline. However, there wasn’t a significant difference between the two groups on the in-clinic test or the first four days of the BRANCH test.
The researchers write, “Our findings suggest that assessing learning over repeated evaluations can reveal disease-relevant decrements in memory during preclinical AD that are less readily observed using single time point assessments.”
As a result, the team believes that using these multi-day tests in future research may help improve early detection of Alzheimer’s and track cognitive decline in preclinical disease.
You can read the whole study here.