There may be early life signs of Alzheimer’s disease risk.
In 1960 a group of nearly 400,000 American high school students took an aptitude test. Today, researchers say the results of that test could predict Alzheimer’s and dementia risk.
How students scored on that test nearly 60 years ago was compared with Medicare data from surviving members of the group to look for correlations with Alzheimer’s. The study further lends credence to the notion that there are early predictors of the disease that can be identified.
Students who performed better had a lower risk for developing the disease, while those that did poorly were associated with increased odds of it.
“The concept that overall cognitive ability is associated with Alzheimer’s risk is not novel,” said Dr. Marc L. Gordon, chief of neurology at the Zucker Hillside Hospital, and professor of Neurology and Psychiatry at the Zucker School of Medicine at Hofstra/Northwell. “This study however goes beyond to look at specific attributes that were tested and seeing how that might affect risk.”
The study, published this month in JAMA Network Open, included a diverse sample of participants from the original test, known as Project Talent, including 43,014 men and 42,749 women now between ages 66 and 73.
Other studies, like those alluded to by Gordon and cited by the researchers, include the Scottish Mental Health Survey, which associated lower mental ability in children age 11 with increased risk of dementia.
The new study goes further by looking at specific testing criteria and how particular types of knowledge are linked with Alzheimer’s and dementia risk rather than just cognitive ability in general.
Areas of cognitive ability on the test included:
- memory for words
- reading comprehension
- mechanical reasoning
- abstract reasoning
- clerical tasks
- visualization in three dimensions
Although there was plenty of crossover, researchers identified certain areas distinct to men and women that could be used to identify greatest risk.
For men, lower scores in mechanical reasoning — questions concerning physical forces such as gravity and basic mechanisms such as pulleys, wheels, and springs — indicated a 17 percent increased likelihood of Alzheimer’s and dementia.
For women, verbal tasks such as memory for words were more indicative. Women who scored lower in memory for words had a 16 percent increased likelihood.
“Women traditionally have better verbal abilities when compared to men, so it may be that if women start off with lower verbal abilities when they are young girls, then as they get older that area that is weaker becomes more apparent in earlier testing,” said Dr. Gayatri Devi, an attending neurologist at Lenox Hill Hospital and specialist in memory loss.
However, both Devi and Gordon, neither of which were directly involved in the study, urge caution in rushing to conclusions about the ability of the test to accurately predict Alzheimer’s and dementia in later life.
“This I think could very easily be misconstrued,” said Gordon.
The significant gap between the testing phase and the collection of Medicare data means that there are plenty of other factors at work in the interim: lifestyle and health choices, education level, and socioeconomic status can all play a role in the development of disease.
“One takeaway I would not have is that this is, as I said, something like a fait accompli, or something that is necessarily unmodifiable,” he said.
For her part, Devi largely praised the study for having a robust cohort but took issue specifically with the use of Medicare data for Alzheimer’s disease.
“They didn’t actually go back and look to see if the older adults had Alzheimer’s; they were kind of correlating it with Medicare data. Therefore, it’s probably not reflective of the actual number of patients who had Alzheimer’s,” she said.
The final question raised in the study is: what exactly should be done with this information? Even if low cognitive ability in children is associated with potential risk later in life for Alzheimer’s and dementia, what should be done about it?
The authors suggest that at-risk individuals could benefit from prevention or intervention efforts, although what exactly that means is unclear.
“I think we don’t know yet if any particular intervention would be efficacious in terms of mitigating the risk — you know whether we should be directly targeting the factor of educational attainment as a risk factor or whether that would interact with other risk factors,” said Gordon.
What is clear though is that even at a young age, brain development and cognitive ability are likely to have a real effect on risk for these diseases, and paying attention to academic problems in kids is likely worthwhile.
However, it doesn’t necessarily mean that kids performing poorly need to be whisked off to tutoring either.
“[The study] is interesting in terms of the idea that our brain is more resilient if we had a better brain to start with,” said Devi. “I think the truth is that we are far more at risk of Alzheimer’s later in our lives and that the intervention should start in our 40s or 50s. But to think about intervening very, very early in life to me seems a little premature.”
Researchers have found that test scores from a 1960 aptitude test may help predict whether people will develop Alzheimer’s disease or dementia.
Researchers identified certain areas distinct to men and women that could be used to identify greatest risk. For men, lower scores in mechanical reasoning indicated a 17 percent increased likelihood of Alzheimer’s and dementia.
Experts said it’s too early to have a test determine definitive Alzheimer’s risk and that the findings need more research.