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The very early stages of Alzheimer’s disease (AD) can be difficult to detect. Changes in the brain can begin a decade or more before memory or thinking problems arise. When the first symptoms appear, they may look like normal forgetfulness.
Recent research on the gut microbiota offers a new way to diagnose Alzheimer’s disease early, when treatment can be most effective.
THE study published on June 14 in Science Translational Medicinefound that people in the earliest phase of the disease, who show no outward signs of decline, have a different composition of microbes in their gut than healthy people.
“Previous studies have shown that the gut microbiomes of people with clinical Alzheimer’s disease [when impairment of memory and cognition is apparent] are different from those of cognitively healthy people,” says the study’s lead author. Aurore Ferreiro, PhD, a postdoctoral research associate at Washington University School of Medicine in St. Louis. “We asked at what point in Alzheimer’s disease progression these gut microbiome differences can be detected – and the answer is quite early. The potential utility of the microbiome in early detection of preclinical Alzheimer’s disease and Alzheimer’s disease risk is supported by these results.
Further evidence of the gut-brain connection
For this analysis, 164 cognitively normal participants between the ages of 68 and 94 were examined by PET and MRI brain scans and cerebrospinal fluid analysis. The researchers were looking for clumps of amyloid beta and tau proteins, which are thought to be hallmarks of Alzheimer’s disease, even in preclinical stages.
Nearly a third (49) presented these indications of early Alzheimer’s.
By examining stool samples, the investigators found that although all subjects ate essentially the same diet (according to their responses to dietary questionnaires), those with accumulations of beta-amyloid and tau had gut bacteria markedly different from their “healthy” counterparts. Dr. Ferreiro notes that his team identified seven species of bacteria that “significantly improved our ability to predict whether or not an individual had preclinical Alzheimer’s disease.”
She points out that the research team does not claim that specific bacteria increase the risk of Alzheimer’s. The results only indicate a link between gut microbiota composition and AD.
Gut microbiome tests could potentially aid in the diagnosis of Alzheimer’s disease
If the results are validated by further study, Ferreiro sees potential for using gut microbiome testing to determine a person’s risk of developing dementia.
“A person reported [for AD] based on gut test results, may be referred for follow-up screening for established biomarkers of Alzheimer’s disease [such as tau and amyloid beta clumps],” she says.
Christophe Damman, MDclinical associate professor of medicine in the division of gastroenterology at the University of Washington, discusses the possibility of improving Alzheimer’s diagnosis through “exciting” gut data.
“Tests using CSF [cerebrospinal fluid] and imaging are good, but if you can improve them, you can more accurately identify people at risk of developing Alzheimer’s disease,” says Dr. Damman, who was not involved in the study. “So it’s a step in the right direction.”
According to Alzheimer Associationearly diagnosis offers a better chance that a patient will benefit from various treatmentsincluding medications and lifestyle changes, such as blood pressure controlstop smoking, exercise more, and stay mentally and socially active.
“Once Alzheimer’s disease is symptomatic, there’s usually neurodegeneration involved, and it’s hard to recover from,” says Ferreiro.
Co-author of the study, Beau Ances, MD, PhDprofessor of neurology at Washington University School of Medicine, foresees a time when people might be able to provide a stool sample and find out if they are at increased risk of developing Alzheimer’s disease.
“It would be much easier and less invasive and more accessible for a large part of the population, especially underrepresented groups, compared to brain scans or lumbar punctures,” Dr. Ances said in a Press release.
Can changing the intestine reduce the risk of Alzheimer’s?
At this point, it is impossible to say whether the microbial changes in the gut are the result of Alzheimer’s disease or whether these changes could influence the disease itself.
Because participants in this survey had essentially the same diet, no conclusions could be drawn about whether diet might have an impact on dementia risk.
So far, there’s no evidence that eating or avoiding a specific food can prevent Alzheimer’s disease or age-related cognitive decline, according to the National Institute of Aging. But the organization says what we eat could affect the aging brain’s ability to think and remember. THE Alzheimer Society indicates that a diet rich in fruits, vegetables and cereals, and low in red meat and sugar helps to reduce dementia risk.
“One would speculate that if you can identify a diet that shifts these microbiome markers in a positive way, then that might be beneficial, but that’s way beyond what the study is telling us,” Damman says.
As for future research, the study authors launched a five-year follow-up investigation designed to determine whether differences in the gut microbiome are a cause or result of the brain changes seen early in the disease. Alzheimers.
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