Health
New Alzheimer’s research reveals ‘quiet’ phase of the disease, before symptoms appear
New details have emerged about how Alzheimer’s disease affects the brain.
Researchers led by the Allen Institute for Brain Science in Seattle and University of Washington Medicine have identified cellular changes in the brains of people with the disease — and a timeline of when they occur.
“Instead of looking at AD just through the usual lens of plaques and tangles, we focused on how specific cell types were changed in each phase,” study author Dr. Kyle Travaglini, Ph.D., a scientist at Allen Institute, told Fox News Digital via email.
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“We identified two main phases in AD by arranging donors along a continuous disease trajectory — a slow, early phase with low levels of pathology and no cognitive decline, followed by a later phase where there’s a huge buildup of pathology and cognitive decline.”
Researchers examine donated brain tissue samples through a microscope in a lab at the Allen Institute. (Allen Institute for Brain Science)
The study, which was published this week in Nature Neuroscience, examined millions of cells from the donated brain tissue of 84 deceased Alzheimer’s patients.
The donors ranged from mild cases with no symptoms to advanced dementia cases.
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“By studying research subjects across the spectrum of AD, including those in the earliest stages of disease, we hope to identify vulnerable cells early in the disease process, long before a person develops symptoms,” C. Dirk Keene, professor of neuropathology at UW Medicine, said in a press release.
Researchers focused on the middle temporal gyrus (MTG) — the part of the brain that controls language, memory and vision.
That portion of the brain is known as a “critical transition zone,” where evidence of Alzheimer’s appears and then worsens as the disease progresses.
A scientist creates a sample in the lab at the Allen Institute. (Allen Institute for Brain Science)
Using machine learning technology, researchers compared the cells, genes and DNA of the Alzheimer’s brain samples to maps of the normal brain generated by the Allen Institute.
“With these tools, scientists were able to detect the earliest cellular changes to the brain to create a more complete picture of what happens over the entire course of the disease,” John Ngai, Ph.D., director of The BRAIN Initiative, said in the release.
“We created a pathology clock that tells not only what changes are happening in this cortical region, but when.”
“The new knowledge provided by this study may help scientists and drug developers around the world develop diagnostics and treatments targeted to specific stages of Alzheimer’s and other dementias,” he added.
Creating a disease timeline
The study identified “two distinct phases” of Alzheimer’s disease.
“You could say we created a pathology clock that tells not only what changes are happening in this cortical region, but when,” said Mariano Gabitto, Ph.D., a lead author and assistant investigator at the Allen Institute, in the release.
Researchers study images of brain tissue to determine Alzheimer’s-related cellular changes. (Allen Institute for Brain Science)
First, there was a “slow, early buildup of abnormal cellular changes,” the researchers noted.
During this period, the patient may not experience any symptoms of memory loss or cognitive decline.
In that first phase, the researchers were surprised to discover the loss of certain inhibitory neurons that were not previously linked to Alzheimer’s.
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Travaglini described that as a “critical discovery,” as those neurons act as “brakes” for brain activity and “keep things balanced.”
“This specificity gives us new clues about how and why certain brain circuits could break down in AD,” he said.
Researchers analyze brain tissue samples in a lab at the Allen Institute. (Allen Institute for Brain Science)
Richard J. Hodes, MD, director of the NIH National Institute on Aging, noted that one of the challenges in diagnosing and treating Alzheimer’s is that much of the damage to the brain happens in this early phase, before symptoms occur.
“The ability to detect these early changes means that, for the first time, we can see what is happening to a person’s brain during the earliest periods of the disease,” he said in the release.
“For the first time, we can see what is happening to a person’s brain during the earliest periods of the disease.”
The second phase was marked by a “much more extensive loss” of different types of neurons and cells, leading to the accumulation of the hallmark “plaques and tangles” in the brain — which is typically when patients begin to notice cognitive decline.
The bigger picture
Igor Camargo Fontana, Ph.D., Alzheimer’s Association director of scientific conference programming in Chicago, was not involved in the study but shared what he described as the “bigger picture” it revealed.
“Instead of looking at AD just through the usual lens of plaques and tangles, we focused on how specific cell types were changed in each phase,” a researcher said. (iStock)
“Alzheimer’s disease has a long pre-symptomatic period; Alzheimer’s-related changes take place in the brain 10, 15 or even 20 years before the onset of memory and thinking symptoms,” he told Fox News Digital.
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“If the findings in this new paper are confirmed by other labs, it raises the question of whether effectively addressing the brain changes that happen in what the authors call the first ‘quiet’ phase can slow, delay or prevent the second, more destructive phase.”
The hope is that this new timeline of how the disease affects the brain will help guide the development of new treatments. (iStock)
Looking ahead, Fontana says it will be important to further investigate the “quiet” phase to confirm how it’s linked to the better-known biomarkers of Alzheimer’s, such as amyloid and tau.
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The hope is that this new timeline of how the disease affects the brain will help guide the development of new treatments, according to researchers.
The study was supported by the National Institute on Aging and the NIH BRAIN Initiative.
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Journalist Katie Couric is sharing a scary medical episode that she experienced on June 27.
In a post on Substack titled “The Day I’ll Never Remember,” she detailed a sudden episode that left her unable to recall the current month, year and president.
“I thought it was 2024. And I believed Joe Biden was president,” she wrote.
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The event occurred while Couric was attending the Aspen Ideas Festival in Colorado, during which she participated in two public panels — one on AI and one on journalism — both of which she cannot remember at all.
“I have no idea what we talked about, or of what occurred when the panels ended,” she said.
Journalist Katie Couric is sharing a scary medical episode that she experienced on June 27. (Getty Images)
John Molner — Couric’s husband, who was in attendance at the festival and the two panels — also shared his account.
After the event, someone told Molner that Katie wasn’t feeling well. When he reached her, an EMT and a doctor were tending to her. “I could tell something was off,” he wrote. “It could have been altitude sickness, but Katie was definitely not all there.”
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At the hospital, when Couric struggled to recall the year, the president and her grandchildren’s names, doctors began checking for a stroke.
An MRI revealed no signs of stroke, which was a relief, but “Katie’s ‘fog’ became a lot more apparent,” Molner wrote.
John Molner, Couric’s husband, who was in attendance at the festival and the two panels, also shared his account. (Getty Images)
“She repeatedly asked me the same questions: ‘What was I doing before we got to the hospital?’ ‘Why am I at the hospital?’”
Couric was ultimately diagnosed with transient global amnesia, a sudden, temporary episode of memory loss that prevents a person from forming new memories and may also erase some recent memories, according to Mayo Clinic.
“The cause seems to be as mysterious as the brain itself.”
It is not caused by a stroke, seizure or head injury, and it usually resolves completely within 24 hours.
“[It’s] just a very weird neural episode that’s pretty uncommon and, at least in most cases, is a ‘one and done’ experience,” Molner said.
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Couric said she finally began feeling “like herself” again around 9 p.m. and went to sleep at 2 a.m.
As TGA leaves a “permanent gap in memory” for the duration of the episode and for hours beforehand, Couric said that from around noon on that day until at least 7 p.m. will remain a “big, black hole.”
As TGA leaves a “permanent gap in memory” for the duration of the episode and for hours beforehand, Couric said that from around noon on that day until at least 7 p.m. will remain a “big, black hole.” (Getty Images)
Data shows that approximately three to eight people per 100,000 will have an episode of transient global amnesia, with people 50 years of age and older at higher risk.
The specific cause of TGA is not known, but some experts believe it stems from a “temporary dysfunction in the brain’s hippocampus — the area responsible for creating new memories,” Couric shared.
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“Doctors believe this is driven by brief interruptions in blood or oxygen flow, or microscopic spasm in the blood vessels.”
Episodes could potentially be triggered by intense physical exertion, emotional distress, extreme temperature changes or migraines, experts say.
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Approximately 15% of patients will have a recurrence 10 years later.
“Why did this happen to me? Was the altitude an issue? Was I dehydrated? Tired? Stressed? The literature doesn’t seem to indicate that these are contributing factors, but the cause seems to be as mysterious as the brain itself,” Couric wrote.
Anyone who experiences sudden memory loss, confusion, difficulty speaking, weakness, numbness, vision changes, severe headache or other stroke-like symptoms should seek immediate medical attention or call 911, doctors advise. (iStock)
“All I know is that those hours will be forever lost. Someone described it as my brain failing to hit the ‘record button.’”
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“While this was a freaky occurrence, it could have been much more serious. So ultimately, I’m relieved — even though several hours of a Saturday in June will always be missing for me.”
Anyone who experiences sudden memory loss, confusion, difficulty speaking, weakness, numbness, vision changes, severe headache or other stroke-like symptoms should seek immediate medical attention or call 911, doctors advise.
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Older adults identified as “super movers” are about half as likely to develop cognitive impairment than their peers.
That’s according to a recent study led by Stony Brook Medicine in New York, which evaluated the cognitive function of 4,000 adults 80 and over who participated in multiple aging and longevity studies over several years.
Among this group, 6% to 10% were classified as super movers, which means they walk at a much faster pace than others of the same age and gender — at speeds comparable to people three decades younger.
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The super movers were found to have about half the risk of cognitive decline compared to seniors with typical gait speed.
The findings were published in the journal Neurology on June 16.
Older adults identified as “super movers” are about half as likely to develop cognitive impairment than their peers. (iStock)
“The study reinforces that mobility and brain health are closely connected,” lead study author Dr. Joe Verghese, MD, neurologist at Stony Brook Medicine, told Fox News Digital. “This suggests that preserving mobility may be an important marker of healthy brain aging and resilience.”
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The most intriguing finding, according to Verghese, was that super movers maintained cognitive function despite having similar dementia-related brain changes as their peers.
In postmortem brain analysis, there was no difference in dementia-related pathologies between the super movers and the slower walkers, the study stated.
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“This suggests they may possess resilience mechanisms that help preserve brain function even in the presence of age-related changes,” he said. “Understanding these resilience factors could lead to new strategies for promoting healthy brain aging.”
As the study was observational, there were some limitations, and it does not prove that walking faster prevents dementia, the researchers noted.
Super movers were found to have about half the risk of cognitive decline compared to seniors with typical gait speed. (iStock)
“Other factors, such as cardiovascular health, physical fitness or genetics, may also contribute to both faster walking and better cognitive outcomes,” Verghese said.
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This study adds to growing evidence that what’s good for the heart and muscles also benefits the brain, he noted, adding that “staying physically active remains one of the most effective, evidence-based ways to support healthy aging.”
“Walking speed is best viewed as a marker of overall health, not a treatment.”
“The broader message is that physical activity is important at any age,” Verghese said. “Walking is an easy step-up point because you don’t need any special equipment. You can do it inside or outdoors, and you can do it on a regular basis. You can walk with a dog, you can walk with a friend.”
Any activity is beneficial if it’s done regularly and with the right intensity, he added.
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Rather than just trying to walk faster, the neurologist recommends that seniors focus on maintaining mobility through regular physical activity, strength training, balance exercises and good cardiovascular health.
“Walking speed is best viewed as a marker of overall health, not a treatment,” Verghese noted.
Major public health guidelines from the CDC and U.S. Physical Activity Guidelines recommend at least 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking.
Major public health guidelines from the CDC and U.S. Physical Activity Guidelines recommend at least 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking. (iStock)
This can be achieved by walking 30 minutes a day, five days a week, or about 20 to 25 minutes most days. Another option is to engage in shorter sessions that add up over the day.
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“You have to do it within your health limitations and medical conditions,” Verghese advised. “So if there are any medical concerns, I would get your physician to clear you before starting exercise.” The good thing about walking, he added, is that you can start at a slow pace and then gradually build up to a brisker pace.
“And then adding on strength and balance training, whatever age you are, I think is also important.”
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