Tests reveal subtle signs of Alzheimer's before clinical symptoms appear

Researchers report that "paper-and-pencil" neuropsychological tests administered to normal subjects averaging 75 years of age contained early signs of cognitive decline in those subjects who later developed Alzheimers disease.

In an analysis of cognitive performance test data from 40 participants enrolled in a long-term study at the UCSD Alzheimers Disease Research Center (ADRC), a research team from the Veterans Affairs San Diego Healthcare System and the UCSD School of Medicine noted subtle evidence of changes that might signal the onset of cognitive decline. All participants were symptom-free when they took the test, with 20 of the subjects diagnosed with Alzheimer disease (AD) within a year or two of testing. The other 20 have remained symptom-free for several years, serving as a matched control group.

When the team compared the data from the cognitive performance tests, they observed significantly greater discrepancies in the cognitive skills of the pre-AD group than in the control group, according to the studys lead author, Mark Jacobson, Ph.D., research psychologist with the VA Healthcare System and assistant project scientist with the UCSD department of psychiatry.

In particular, the results revealed early asymmetric decline, with the pre-AD subjects showing larger and more frequent discrepancies in their ability to perform visual versus verbal tests. These changes occur unevenly, affecting certain performance measures and not others, indicating subtle patterns of deterioration of specific regions of the brain affected by AD.

"We saw a larger discrepancy between the results of the non-verbal spatial tests and the verbal tests in the subjects who later were diagnosed with Alzheimers disease," said Jacobson. "Since these changes are very subtle and not noticeable if you are only looking at one single area, our findings suggest that we should be comparing performance in different areas as they relate to one another to detect

Contact: Leslie Franz
University of California - San Diego

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