One of the challenges medicine faces in combating Alzheimer’s disease or slowing the progression of the cognitive decline it causes is that the first symptoms of Alzheimer’s appear when the disease has already damaged the patient’s brain. Early diagnosis of this type of dementia would help improve its prognosis, but the available diagnostic techniques are expensive and invasive. Now, a group of scientists has discovered that formic acid can be a useful urinary biomarker for detecting Alzheimer’s in its early stages, and that a simple urine analysis would allow those affected to be identified when they have not yet manifested symptoms.
The results of the research have been published in Frontiers in Aging Neuroscience and suggest that this method of diagnosing Alzheimer’s early could lay the foundation for developing large-scale detection programs. “Alzheimer’s disease is an ongoing, hidden chronic disease, meaning it can develop and last for many years before overt cognitive decline emerges,” the authors said. “The early stages of the disease occur before the irreversible dementia stage, and this is the golden window for intervention and treatment. Therefore, there is a need for large-scale screening for early-stage Alzheimer’s disease for the elderly.”
Urinary formic acid, a marker of cognitive impairment due to Alzheimer’s
Diagnostic techniques currently used to detect Alzheimer’s include PET scans of the brain, which are expensive and expose the patient to radiation. There are also biomarker tests, but this requires invasive blood draws or a lumbar puncture to obtain cerebrospinal fluid, which can be uncomfortable for patients.
“The early stages of Alzheimer’s occur before the irreversible dementia stage, and this is the golden window for intervention and treatment.”
A urine test is non-invasive and would facilitate detection on a large scale. Although urinary biomarkers for Alzheimer’s disease have been identified before, none have been effective in detecting the disease in its early stages, meaning that the “golden window” for early treatment remains elusive.
The researchers studied 574 people: a large group of Alzheimer’s patients at various degrees of disease progression, and healthy volunteers with normal cognition who served as controls. They analyzed urine and blood samples from all the participants and also subjected them to psychological evaluations.
They found that urinary formic acid levels were significantly increased in all Alzheimer’s groups compared with healthy individuals, including a group of patients with early-stage subjective cognitive impairment, and correlated with cognitive decline. The findings suggest that formic acid could act as a sensitive biomarker for early-stage Alzheimer’s disease, although further research is needed on the relationship between formic acid and Alzheimer’s.
Furthermore, when these scientists analyzed urinary formic acid levels in combination with Alzheimer’s biomarkers in the blood, they found that they could more accurately predict which stage of the disease a patient was experiencing. “Urinary formic acid showed excellent sensitivity for the early detection of Alzheimer’s disease,” the authors state. “Urine biomarker screening for Alzheimer’s disease is convenient and cost-effective, and should be performed during routine physical examinations of the elderly.”
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