Early Signs of Memory Loss May Indicate Presence of Tau Tangles in the Brain
Individuals who experience early memory difficulties and whose partners agree that there may be memory problems often have higher levels of tau tangles in the brain, according to a study led by researchers from Massachusetts General Hospital (MGH) and Brigham and Women’s Hospital. Tau is a protein in the brain that can form tangles within neurons, causing them to stop functioning normally and eventually die. Tau tangles are a common biomarker associated with Alzheimer’s disease (AD).
Researchers are hopeful that if people who have AD biomarkers, but only mild symptoms, can be identified, they may be able to begin disease-altering medications. So far, these medications have shown some effectiveness if started in AD’s earliest stages. “Understanding the earliest signs of Alzheimer’s disease is even more important now that new disease-modifying drugs are becoming available,” says study author and clinical neuropsychologist Rebecca E. Amariglio, PhD, with MGH and Brigham and Women’s. “Our study found early suspicions of memory problems by both participants and the people who knew them well were linked to higher levels of tau tangles in the brain.”
Tracking Tau
The study, published recently in the journal Neurology, involved 675 adults (average age of 72) with no cognitive impairment at the start of the study. All of the participants also had a study partner, such as a spouse, adult child, or friend who could answer specific questions about the person’s memory and thinking skills. In most cases, the study partner lived with the participant.
Each participant and partner completed questionnaires to assess the individual’s subjective cognitive decline. Subjective cognitive decline describes self-reported changes in memory and thinking skills that are not significant enough to show up on standard, objective cognition tests. Questions included, “Compared to one year ago, do you feel that your memory has declined substantially?” and “Compared to one year ago, do you have more difficulty managing money?” The responses were scored, with higher scores indicating greater complaints about memory.
Study participants also had brain scans for tau and amyloid plaque, another toxic brain protein that, at high levels, is a biomarker for AD. About 60 percent of the participants had elevated amyloid levels, meaning that they were at higher risk for cognitive impairment, even though they had normal cognitive functioning at the start of the study. Tau buildup tends to be greater when there are also higher amyloid levels.
In the study, researchers found that participants with higher levels of tau tangles had higher memory complaint scores. Their partners also scored them higher. The association was even stronger when amyloid plaques were also detected.
“Our study included a high percentage of people with elevated amyloid, and for this reason we were able to also see that memory complaints were associated with higher tau tangles,” Dr. Amariglio says. “Our findings suggest that asking older people who have elevated Alzheimer’s disease biomarkers about subjective cognitive decline may be valuable for early detection.
This is particularly important since it is predicted that treatments given at the earliest diagnosable form of the disease will be the most effective in slowing the disease.”
Takeaway
While you may look at any memory change as cause for concern, it’s important to understand that occasional memory lapses or struggles with word finding aren’t always early signs of dementia. It’s normal for age-related changes in memory and other brain functions to occur a little more often as the years go by. Other factors, such as medication side effects, insufficient sleep, vitamin B12 deficiency, and conditions such as urinary tract infections can cause temporary, but often reversible, changes in memory and cognition.
Because memory problems can stem from chronic, progressive conditions such as AD, as well as other factors, it’s always important to pay attention to memory lapses and to any other thinking-skills changes. Have honest and open conversations with family members about their observations. Also talk with your primary care doctor, who may give you a simple cognitive test as an initial screening. From there, you may be given some reassurance that your memory changes are not a reason for concern or that seeing a neurologist or neuropsychologist may be a good next step.
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