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French neurologist hopeful on early Alzheimer’s diagnosis

A prominent French neurology professor has suggested that a network of “memory centres”, and a new smartphone app, could help with ongoing “hopeful” research into early diagnosis of Alzheimer’s disease.

The news comes during World Alzheimer's Month and World Alzheimer's Day today (September 21), which both seek to raise awareness of the condition and promote groundbreaking research on its possible cure.

He said: “We are no longer simply examining the illness. We are perhaps on the path towards a solution.”

Professor Dubois said that he would speak more about “the idea of creating preventative dementia centres” during a conference at the Académie de Médecine tomorrow (Tuesday September 22).

He said: “I imagine them to be structures identifying some risk factors, which could then be improved by targeted interventions [and treatments]. In addition, we are developing - alongside the Agence Régionale de Santé (ARS) of Île-de-France, a smartphone application that would help pick up cognitive difficulties.

“This project, called Santé-Cerveau (Health-Brain) would allow people to evaluate themselves via questionnaires and marked tests. This would indicate their cognitive function, and if they need it, they will be put into contact with the closest 'memory centre’ near them. By getting the population involved, we can hope to delay the illness a little.”

Encouraging research

Professor Dubois’s team is currently awaiting the results of a high-profile clinical trial of a new Alzheimer’s treatment by the American company Biogen.

He explained that recent tests in the field appeared to show that new drugs were able to reduce the cognitive decline among patients in the early stages of the disease, and had a positive effect on patient independence and cognitive performance. He called this “a promising first” finding.

If the results are confirmed next year he said: “[The year] 2021 will be the second-most important date since Aloïs Alzheimer first described the illness in 1906.”

Professor Dubois also explained that other drugs and medication against the disease were in development or trial, and were showing “encouraging results”.

He explained that while treating people who were already in the later stages of the disease “was too late”, the researchers’ and doctors’ overall goal was to diagnose the illness as early as possible, while patients still retain autonomy and have very few symptoms, if any - and to slow or stop any symptoms from worsening.

He said: “For this, we can look at the enormous progress seen in [research on] the biological markers associated with the presence of lesions [on the brain]. Some of these markers are present 15 years before the arrival of symptoms. [In theory] therefore we should be able to identify healthy, at-risk patients, and stop the illness from arriving.

“I have the idea of going from a bit of a fatalistic vision, helping ill people; to an earlier, wider, more dynamic approach. We would need to explain to these people that they are not ill, but merely at-risk. It seems like medical fantasy, but if these medications keep their promises, we could imagine that some of them could be given as preventive measures.”

Researchers have also been studying a group of 318 older people since 2013, none of whom had any cognitive issues at the start of the trial, as part of a wider brain study financed by l'Institut du Cerveau et de la Moelle Épinière and research foundation la Fondation pour la Recherche sur Alzheimer.

This study is partially designed to help scientists better understand how to spot at-risk patients earlier, and learn more about how symptoms develop.

There is still disagreement in the scientific community over the effectiveness and predictability of early indicators of the disease, but one of the overall goals could be to “develop an algorithm” that could predict who among a population is likely to develop the illness, Professor Dubois said.

And while he explained that his team had seen some suggestion of a correlation between blood markers and lesions in the brain, we are still very far from being able to diagnose Alzheimer’s with a simple blood test, Professor Dubois said.

Currently, doing research on humans is laborious because it requires monthly hospital visits by people in their 60s, as well as requiring them to undergo lumbar punctures, and regular blood tests.

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