By measuring ratios of two fatty compounds in blood, doctors are now better able to predict how rapidly somebody with Alzheimer’s disease is likely to lose cognitive function, researchers from Johns Hopkins University School of Medicine reported in the Journal of Alzheimer’s Disease. The authors explain that being able to predict cognitive decline could be useful for treatment targets, as well as providing loved ones and caregivers with vital data regarding what to expect and how to prepare.

Out of approximately 100 patients with newly diagnosed Alzheimer’s, approximately 33 will experience virtual no cognitive decline during the first five years, 33 will lose cognitive function at a moderate rate, while the other 33 will deteriorate rapidly. An accurate prediction of what there is to come could help individuals with the disease as well as those who are likely to be caring for them to prepare. Doctors could also benefit by deciding which of their Alzheimer’s patients would best benefit from aggressive treatment.

The authors explain that there are no current treatments that effectively prevent, stop or slow down AD (Alzheimer’s disease),. They added that even in their present study, further tests are required before the blood fat test can be demonstrated as reliable.

Michelle Mielke, Ph.D., adjunct assistant professor of psychiatry, wrote:

“We’re confident there’s a relationship between these lipids and AD progression, but this work is not yet ready to be used clinically.”

Michelle Mielke and team gathered and analyzed data from 120 patients with probable Alzheimer’s at the Alzheimer’s Disease Memory Disorder Center, Baylor College of Medicine, Texas. They measured a range of blood fat levels, and carried out cognitive assessments over a 2.3 year-period. Each patient was visited on average 4.2 times.

They found that a slower progression of dementia in Alzheimer’s disease was linked to lower blood levels of ceramide and higher levels of plasma sphingomyelins. These are two kinds of fats found in cells throughout the human body.

The authors explained that ceramides play a role in cell death and inflammation. If there are fewer ceramides in the bloodstream, a small number of brain cells are being killed off, resulting in slower progression of the disease.

Mielke said that a prior study had demonstrated that ceramide blood levels were linked to faster shrinkage of the brain’s memory center over a 12-month period in individuals with mild cognitive impairment. Some studies have also associated ceramide levels with amyloid beta levels. Amyloid beta is a protein which accumulates in patients with AD.

If this blood test is proven to be effective in further studies, the researchers believe there may be ways to slow down cognitive decline.

The researchers said:

“An enzyme known as sphingomyelinase metabolizes sphingomyelins into ceramides. It is possible, that if a sphingomyelinase inhibitor were used to slow down the process of breaking down sphingomyelins into ceramides, the progression of the disease could be interrupted.

Huge effort and a great deal of resources have gone into finding ways to stop Alzheimer’s disease. To date, the only approved therapy helps cognitive decline symptoms in some individuals, and then for a short time only. No current treatment has had any effect on the course of the disease.

Mielke said:

“And none of the other compounds in clinical trials to date are showing any benefits. Perhaps we need to shift our focus. The answers could be in these lipids, which can be measured in the blood.”

Written by Christian Nordqvist