Researchers now understand that the Alzheimer’s disease process begins long before symptoms appear in individuals. This beginning of Alzheimer’s disease is referred to as the preclinical or cognitively normal stage. At this point, individuals show no apparent signs of decline in memory, language, orientation, and problem-solving skills. They are typically able to carry out day-to-day activities independently and engage in social interactions without any noticeable difficulties. However, we now know that subtle changes are occurring within the brain that will eventually lead to the development of more pronounced symptoms in the later stages of the disease.
Why Focus on the Preclinical Stage of Alzheimer's Disease?
The preclinical stage of Alzheimer's disease (AD) is a crucial window for early detection and potential reversal of AD's neuropathological damages. Because there are no cognitive symptoms, treatment during this phase has the opportunity to stop Alzheimer’s symptoms before they start, as minimal irreversible damage has occurred at this point. With preclinical treatments, we aim to stop the progression of the disease before it starts, providing the best opportunity to combat AD.
What Are We Testing In The Preclinical Stage of Alzheimer's Disease?
Research at this stage often involves testing for early molecular players (using biomarkers)—Amyloid-beta (Aβ) peptide and tau protein. The buildup of these proteins in the brain leads to neurodegeneration, a hallmark of AD. Understanding their role is crucial in our fight against the disease. This means that clinical trials and therapeutics are mainly focused on two areas: Anti-Aβ Therapeutics, aiming at preventing and dissolving Aβ plaques, and Anti-Tau Therapeutics, focusing on tau protein, which forms neurofibrillary tangles contributing to AD. In addition, the preclinical stage is where we can test non-pharmacological treatments such as behavioral or lifestyle adjustments.
Future Outlook?
We are constantly learning more about preclinical AD, and the research holds great promise. One of the key challenges at the moment is participant recruitment and inclusivity in the preclinical stage of AD research. There is a need for an efficient system for identifying and prescreening high-risk individuals. Innovative projects like the TRC-PAD Initiative and Alzheimer’s Prevention Trial Webstudy are making strides in early detection by gathering data to predict AD risks. Moreover, the potential of blood tests, which can detect AD-related abnormalities even before traditional PET scans, represents a significant advancement in early intervention. As we continue to push the boundaries of technology and research, we foresee a future where early treatment becomes a norm, significantly reducing neurodegeneration in AD patients.
How Can You Participate?
Remember, there are no definitive cures for Alzheimer's disease and dementia, but early detection and intervention can significantly improve the quality of life for those living with dementia and their loved ones. By educating oneself about the disease and supporting those affected by it, we can create a more informed and compassionate society that is better equipped to help those affected by Alzheimer's disease. Those interested can consult their primary healthcare providers, reach out to ATRI, or search for ongoing trials in their area.
