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It is often said that “the eye is the window to the soul.” Now, Alzheimer’s disease research reveals that it may be a window into the brain as well, in a much more literal sense.
You may have read that Alzheimer’s disease is characterized by amyloid plaques and neurofibrillary tangles in the brain. Amyloid plaques are found in the tissue between nerve cells; they are made up of clumps of a protein called “beta-amyloid” as well as degenerating bits of neurons and other cells. Neurofibrillary tangles are bundles of twisted filaments within neurons, largely composed of a protein called “tau.”
Investigators from Cedars-Sinai examined retinal and brain tissue samples collected from 86 individuals over the span of 14 years. What they found has significant implications for the way we think about, and deal with, Alzheimer’s disease.
The Cedars-Sinai Alzheimer’s Disease Case Study
The team of investigators at Cedars-Sinai, whose results were published in Acta Pathologica, a peer-reviewed journal, examined samples from people who had had Alzheimer’s disease and mild cognitive impairment (an earlier stage of Alzheimer’s). They looked at samples from both early- and later-stage Alzheimer’s disease patients as well as samples from individuals with normal cognitive function.
The investigation considered the physical features of the subjects’ retinas, the light-sensitive tissue at the back of the eye that receives images and conveys them to the brain through the optic nerve. Investigators measured functional cell loss and markers of inflammation, paying close attention to proteins found in the subjects’ brain and retinal tissues. Among the findings from the retinal tissue:
- Excessive amounts of amyloid beta 42 protein, which has previously been found in the amyloid plaques in Alzheimer’s patients’ brains after death
- Accumulated amyloid beta protein in ganglion cells, which transmit visual input from the retina to the optic nerve
- Increased numbers of astrocytes and immune cells (microglia) closely surrounding amyloid plaques
- Up to 80% fewer microglial cells clearing amyloid beta proteins from the retina and brain
- Certain molecules and biological pathways associated with inflammation as well as cell and tissue death.
Investigators noted that the changes in the retina correlated with changes in parts of the brain that deal with memory, navigation, and the perception of time. The changes to patients’ retinas correlated to the stage of advancement of Alzheimer’s disease known as the Braak stage, as well as to the cognitive status of patients. And because these retinal changes were found even in subjects who appeared to be cognitively normal or who had very mild impairment, there is hope that observation of retinal changes may become a non-invasive way to predict future cognitive decline.
What the Alzheimer’s Disease Study Means for Families Now
While the Cedars-Sinai investigation provides new insights and potential direction for future Alzheimer’s disease research studies, it doesn’t address the concerns of families who are living with Alzheimer’s now, or who will be dealing with it in the near future. Hopefully, continued Alzheimer’s disease research will lead not only to the ability to predict Alzheimer’s as early as possible, but to the ability to cure or even prevent it.
In the meantime, it’s more important than ever for families and individuals to plan for a loved one’s Alzheimer’s care. Early on in the stages of Alzheimer’s disease, it may be difficult for family members to discern that there are cognitive changes taking place. But if you have concerns about yourself or a loved one, perhaps due to family history, it’s never too early to know your options and put resources in place.
There are things you can do to maintain brain health as you age and perhaps reduce your risk of developing Alzheimer’s disease, many of which promote your overall health, as well. Even if you (or your older family member) feel perfectly fine, it’s a good idea to request that the doctor perform a cognitive screening as part of an annual Medicare wellness visit. Doctors should be performing these brief, non-invasive screenings during older patients’ wellness visits, but the truth is that many don’t unless the patient or their family asks—and few patients do. Cognitive screenings are important because although there is not yet a cure for Alzheimer’s disease, early care may help to slow the progression of Alzheimer’s and preserve the quality of life.
And if your loved one has been diagnosed with Alzheimer’s or mild cognitive decline, it’s all the more important to marshal resources and ensure that their needs are met. Doing so can include even small steps, like giving your family member access to technology and apps for people with cognitive decline. Putting your Alzheimer’s “toolkit” together also means taking bigger steps, like consulting with an elder law attorney who regularly helps families with Alzheimer’s-related issues.
Dealing with Alzheimer’s disease can be overwhelming for family members, whether they live far away or are providing daily care for a loved one with dementia. An experienced elder law attorney can answer questions, help you know what to expect, and even help you to consider and address issues that might not have occurred to you.
To learn more about Alzheimer’s disease research or to plan for yourself or a family member with Alzheimer’s, contact Estate Planning & Elder Law Services to schedule a consultation.