Study identifies four distinct clusters of symptoms that can possibly advance to Alzheimer's
Alzheimer's disease
-- an ageing-related condition in which memory and speech steadily declines, eventually disrupting daily activities.
Researchers from the University of California, Los Angeles, US, said the study offers new insights into how the disorder can develop over time rather than from isolated risk factors.
"We found that multi-step trajectories can indicate greater risk factors for Alzheimer's disease than single conditions," first author Mingzhou Fu, a medical informatics pre-doctoral student at the University of California, said.
"Understanding these pathways could fundamentally change how we approach early detection and prevention," Fu said.
The study, published in the journal eBioMedicine Part of THE LANCET Discovery Science, analysed records from the 'University of California Health Data Warehouse'.
From data of more than 5,700 patients, nearly 6,800 unique sequences or 'pathways' were discerned, revealing how conditions can progress step-by-step towards Alzheimer's disease.
The psychiatric cluster of symptoms were classified under the '
mental health pathway
', which is centred on a depressive episode, and can potentially develop into Alzheimer's, the researchers said.
Common diagnoses preceding depression can include hypertension, type 2 diabetes and intestinal disorders, the team said.
The '
encephalopathy pathway
' -- analysed to be the "most aggressive" -- includes conditions related to brain dysfunction that escalate with time, preceding stages of which can involve cerebrovascular and urinary diseases, among others.
The encephalopathy cluster showed the quickest progression to Alzheimer's disease and subsequent death, the researchers said.
The '
mild cognitive impairment pathway
' -- the third cluster of symptoms -- encompasses problems with cognition or thought processes, especially memory. Preceding stages were found to include menopause and male erectile dysfunction, among others.
The fourth cluster of symptoms forming the '
vascular disease pathway
' looked at conditions affecting blood flow to the brain, potentially causing a stroke or neurological defects.
These could be preceded by disorders of the joint and soft tissue, and chronic pain conditions, such as back pain, the researchers said.
Around 26 per cent of the 6,800 unique progressions outlined in the study were found to show consistent directional ordering -- for example, hypertension often preceded depressive episodes, which then increased Alzheimer's risk, the team said.
"Recognising these sequential patterns rather than focusing on diagnoses in isolation may help clinicians improve Alzheimer's disease diagnosis," lead author Timothy Chang, assistant professor of neurology at the University of California, said.
The authors wrote, "5,762 patients contributed 6,794 unique (Alzheimer's disease) progression trajectories, revealing four major trajectory clusters: mental health, encephalopathy, mild cognitive impairment, and vascular disease." PTI KRS KRS MNK MNK
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