On the verge of what some experts consider to be an Alzheimer’s crisis, scientists at the School of Medicine are revealing important details concerning the disease’s destructive neurological effects.

The eldest members of the baby boom generation, a significant segment of the United States population, will soon turn 60. Consequently, studies show that the prevalence of Alzheimer’s disease in the U. S. is likely to surge sharply upward in the upcoming decades, straining already overburdened health care systems.

In light of this crisis, the National Institute of Health (NIH) and other organizations are funding scientists like Lei Wang, a research associate in psychiatry at the School of Medicine, who are interested in the pathology of this disease.

Wang and colleagues at the Silvio Conte Center for Neuroscience Research and the Alzheimer’s Disease Research Center at the School of Medicine are trying to pinpoint crucial changes in the brain’s structure that can distinguish individuals who are aging normally from those with mild, early-stage Alzheimer’s disease. Using magnetic resonance imaging (MRI) technology, Wang and colleagues have identified brain structures that show significant abnormalities in Alzheimer’s patients.

Alzheimer’s disease is currently the number one cause of dementia, an umbrella term for progressive degenerative brain syndromes that effect basic cognitive functions like memory, emotions, thinking and behavior. Upon onset, “plaques” and “tangles” begin to permeate certain areas of the brain, disrupting signal pathways and altering normal brain functions.

Unfortunately, these “plaques” and “tangles” in the brain can only be observed post-mortem, via autopsy, so doctors cannot readily diagnose and treat the disease until symptoms manifest themselves in a given patient.

Wang and colleagues are approaching Alzheimer’s disease from an entirely different angle, namely by focusing on imaging a structure in the brain called the hippocampus. As humans age, this area of the brain gradually deteriorates and shrinks in size. After conducting brain scans on 18 Alzheimer’s patients and 26 normal individuals, the scientists noticed a pattern: in Alzheimer’s patients, the hippocampus loses size much more rapidly and undergoes significant changes in shape.

“There were changes in normal people, too,” said Wang. “But the changes were more pronounced in people with mild Alzheimer’s disease. At the start of the study, there were some differences between the two groups, but at the two-year follow-up, the pattern of the changes had spread to a wider region of the hippocampus in people with Alzheimer’s disease.”

Another recent study confirmed that Alzheimer’s diagnosis is posing a serious problem, concluding that four out of five Alzheimer’s patients were not diagnosed by their family physicians in the early stages of their disease. Considering that it may soon be possible to avert the severe consequences of Alzheimer’s altogether with early diagnosis, Wang and colleagues’ findings could play an important role in developing a tool for Alzheimer’s diagnosis and prediction.

This is one of scientists’ most desired goals: to characterize morphological changes in brain structures, such as the hippocampus, that can predict a patient’s future risk for Alzheimer’s disease. John G. Csernansky, director of the Conte Center, acknowledges the challenges ahead.

“I would say that it is our hope that these types of methods will one day be clinically applicable,” said Csernansky, “But to make that happen, we will eventually have to find differences between DAT [dementia of the Alzheimer's type] and other dementing diseases as well as between DAT and healthy aging.”

By the year 2030, the youngest of the baby boomers will be over 65 years old. By that point, according to a study published in the Archives of Neurology, the prevalence of Alzheimer’s disease in the U.S. is expected to increase by 70 percent, affecting a total of 7.7 million people.

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