What is the critical indicator of detecting Alzheimer's? Perhaps it is the degree of change over time, indicated at our study at Stanford and now also the claim resulting from a study done at the Mayo Clinic in Scottsdale, AZ tracking people who possess a so-called 'genetic marker' for the disease (the APOE e4 gene), just published in the most recent issue of the journal Neurology.

Alzheimer's symptoms show early as 50s - Signs unrecognized, Mayo study finds.

Kate Nolan
The Arizona Republic
Jun. 26, 2004 12:00 AM

Just as baby boomers suspected.

You can have symptoms of Alzheimer's disease in your 50s and not even know it, says a new study.

But it's not as simple as misplacing your keys or enduring some other so-called senior moment, says Dr. Richard Caselli, co-author of the study and head of the department of neurology at Mayo Clinic in Scottsdale.

"We all misplace our keys sometime. What's key in diagnosing Alzheimer's is a pattern of forgetfulness that is worsening," Caselli said. And, often, the presence of a genetic marker, the APOE e4 gene, at least in the late onset version of the disease.

As part of the Arizona Alzheimer's Disease Consortium, Caselli and Mayo are studying people in their 50s who have the gene.

Most people who develop late-onset Alzheimer's disease are typically around age 70 when it is diagnosed.

Scientists have studied their mental declines after diagnosis. But until now, little data existed on how or when the symptoms first arise.

Caselli and fellow researchers wanted to find out, and decided to study younger people who had no symptoms.

The results appear in a paper, co-written by Caselli, in the June 8 edition of Neurology, the journal of the American Academy of Neurology.

In the study, more than a hundred men and women, ages 50 to 59, were tested for certain mental abilities over time. Some had the gene marker; some didn't. All were healthy; most were related to someone who'd had the disease.

At intervals over six years, various tests were given to assess mental skills. In one test, participants heard a list of 15 words and then were asked to recall them. In another, they looked at a complicated picture and later had to draw it. Ten minutes later they were asked to draw it again.

"The importance of the tests was measuring changes," Caselli said. Based on performance, it wasn't clear who did or didn't have the gene. It was the degree of change from one test to the next, he said.

On tests, decline in memory was much more pronounced among people who had the gene. But the loss was not evident in everyday life. Researchers also saw a rise in depression and feelings of paranoia - characteristics of some Alzheimer's patients - in those with the gene.

Caselli concludes that neurological degeneration may start many years before the symptoms are noticed.

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