Health
Alzheimer’s patients divided into 5 subgroups, potentially enabling ‘personalized medicine,’ study finds
Researchers have identified a total of five subgroups among Alzheimer’s patients, according to a new study published in the journal Nature Aging on Jan. 9.
Different groups may require different treatment options, as noted in a press release from Alzheimer Center Amsterdam, Amsterdam UMC and Maastricht University.
“Previously, it was thought that Alzheimer’s disease is one disease, and that treatments being developed will work similarly for all individuals,” lead researcher Betty Tijms, associate professor of neuroscience and brain imaging at Amsterdam UMC, told Fox News Digital in an email.
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“We found that patients with Alzheimer’s disease differ in the biological processes involved — which means that possibly treatments will only work for a subgroup of patients.”
In the study, the researchers analyzed 1,058 proteins in the cerebrospinal fluid of 419 people with Alzheimer’s disease from studies at the Alzheimer Center Amsterdam.
Researchers have identified a total of five subgroups among Alzheimer’s patients, according to a new study published in the journal Nature Aging. Different groups may require different treatment options. (iStock)
They identified five different variants, according to the release describing the findings.
The first group had increased amyloid production in the brain, which results in a buildup of plaques that impede cognitive function, a hallmark of Alzheimer’s.
“This may explain why some patients respond better to some treatments.”
A second group was found to have a disruption in the blood-brain barrier, reduced amyloid production and less growth of nerve cells.
The remaining groups showed differences in protein synthesis, immune system function and cerebrospinal fluid production, the researchers noted.
Some of the groups were found to have faster progression of symptoms than others.
In the study, the researchers (not pictured) analyzed 1,058 proteins in the cerebrospinal fluid of 419 people with Alzheimer’s disease from studies at the Alzheimer Center Amsterdam. (iStock)
In an earlier, smaller study, the researchers found three subtypes (aberrant neuroplasticity, innate immune activation and blood-brain barrier dysfunction), Tijms noted.
“In our new, larger dataset, we again found those three subtypes, but also two new subtypes, with underlying processes that we did not expect to find beforehand,” she said.
One of those new subtypes was rare, including only 6% of the patients — but it had the worst disease prognosis, the researcher said.
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“This subtype had problems with protein synthesis,” she said. “The other subtype had impairment of the choroid plexus, which is the organ in the brain that produces cerebrospinal fluid.”
The study did have some limitations, the researchers acknowledged.
“While we expect that subtypes may have different response to treatment, we were not yet able to demonstrate this, because we need access to cerebrospinal fluid samples from existing drug trials,” noted Tijms.
“We hope to test this in future studies.”
Based on the new findings about Alzheimer’s, treatment response and side effects could differ between patients from different subtypes, the researchers said. (iStock)
Additionally, the study was performed among relatively young patients, with an average age of 66 years.
“Subtypes may be different at older ages, as the majority of patients with AD are 80 years and older),” Pieter Jelle Visser, associate professor of neuroscience at Amsterdam UMC, told Fox News Digital.
Based on these findings, researchers involved in treatment development should take into account that treatment response and side effects could differ between patients from different subtypes, Visser noted.
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“For example, they could define the subtypes of patients to identify the ones who best respond to the trial,” he said. “This could also be done with samples that already have been collected in previous trials.”
Researchers could also test novel treatments only in a subtype that is likely to respond to the treatment, Tijms added, such as testing immune treatment in the subtype with immune activation.
“Each subgroup may need its own treatment, or version of a treatment, or combination of treatments, in order to be effective with the least side effects,” said a doctor from the Alzheimer’s Association. (iStock)
Dr. Kirk C. Wilhelmsen, professor of neurology and chief of cognitive neurology at West Virginia University Rockefeller Neuroscience Institute, said this research is an “important paper,” but noted that it’s not ready to be implemented in clinical practice.
Wilhelmsen was not involved in the study.
“This may explain why some patients respond better to some treatments,” he told Fox News Digital. “It may salvage some drugs that have failed in clinical trials.”
Researchers said the hope is that the identification of these subgroups may salvage some drugs that have failed in clinical trials. (iStock)
Dr. Claire Sexton, senior director of scientific programs and outreach at the Alzheimer’s Association in Chicago, noted in a statement to Fox News Digital that while there are common brain changes that define Alzheimer’s, the experience of the disease varies from person to person.
“Now we are learning more about how some aspects of the biology of Alzheimer’s may also be different for different patients,” said Sexton, who was also not a participant in the Amsterdam research.
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“This includes differences in symptoms, the speed of progression and response to treatments,” she went on.
“Research that gives us a better understanding of the biology of Alzheimer’s disease can … inform therapeutic possibilities and drug development, and may advance the field toward personalized medicine approaches.”
A patient who suffers from Alzheimer’s is shown preparing to receive a PET scan at MedStar Georgetown University Hospital in Washington, D.C., on June 20, 2023. (Michael Robinson Chávez/The Washington Post via Getty Images)
If these subtypes are validated and confirmed, Sexton said, they may help to explain why some individuals do or do not respond to certain treatments, or experience different types and severity of side effects.
“Each subgroup may need its own treatment, or version of a treatment, or combination of treatments, in order to be effective with the least side effects,” she said.
To confirm these findings, Sexton called for additional research with larger study groups that “accurately represent the diversity of the at-risk and affected populations.”
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Research continues to uncover new details on how fasting may help extend life.
A new study published in the journal Nature Communications investigated how intermittent fasting can boost longevity in small worms often used in aging research.
Researchers from the University of Texas Southwestern Medical Center in Dallas compared worms that were fed normally to those that underwent a 24-hour fast in early adulthood and were then fed again, according to a press release.
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The scientists measured a variety of factors, including stored fat, gene activity related to fat metabolism and lifespan.
The results showed that the life-boosting benefit did not depend on the fasting itself but on the body’s behavior after eating again.
Experts say sustainability is key when choosing a long-term weight-loss strategy. (iStock)
Study lead Peter Douglas, associate professor of molecular biology and a member of the Hamon Center for Regenerative Science and Medicine at UT Southwestern, suggested that these discoveries “shift the focus toward a neglected side of the metabolic coin – the re-feeding phase.”
“Our data suggest that the health-promoting effects of intermittent fasting are not merely a product of the fast itself, but are dependent on how the metabolic machinery recalibrates during the subsequent transition back to a fed state,” he said.
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“Our findings bridge a gap between lipid metabolism and aging research,” he added. “By targeting aging, the single greatest risk factor for human disease, we move beyond treating isolated conditions toward a preventive model of medicine that enhances quality of life for all individuals.”
Lauri Wright, director of nutrition programs at the University of South Florida’s College of Public Health, called this a “high-quality” study that adds an “important nuance to how we think about fasting and longevity.”
Intermittent fasting typically involves limiting meals to an eight-hour daily window or fasting every other day. (iStock)
The benefits of the refeeding phase after fasting were “especially interesting,” Wright, who was not involved in the study, told Fox News Digital.
“The researchers showed that longevity was linked to the body’s ability to turn off fat breakdown after fasting, allowing cells to restore energy balance,” she reiterated.
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“From a scientific standpoint, that’s a meaningful shift because it suggests fasting is not just about burning fat, but about metabolic flexibility.”
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Fasting may support longevity through triggering metabolic switching, enhancing cellular repair and stress resistance and improving markers like insulin sensitivity, research shows.
Limitations and cautions
Although this study provides “important insight” on the power of refeeding, Wright noted that the findings should be approached with caution, as the study was done on worms and cannot always be translated to humans.
“Additionally, it explains how a process might work in a controlled lab condition rather than real-world eating behaviors,” she added as a limitation. “Finally, the study is short-term and doesn’t give us the long-term translation on lifespan outcomes.”
The review found intermittent fasting was barely more effective than doing nothing, according to the study authors. (iStock)
Wright cautioned that fasting is “not a magic solution for longevity, and how you eat overall matters more than when you eat.”
“I advise, first and foremost, to focus on diet quality, including a variety of fruits and vegetables, healthy fats and minimally processed foods,” she said.
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For those who are considering fasting, it’s better to stick with a moderate plan — like a 12- to 14-hour overnight fast — rather than going to extremes, Wright said. After fasting, she recommends focusing on well-balanced meals.
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Several groups of people should be cautioned against fasting, according to Wright, including those with diabetes who are on insulin or hypoglycemic medications, those who are pregnant or breastfeeding, anyone with a history of eating disorders and older adults at risk of malnutrition.
Anyone considering intermittent fasting should consult with a doctor before starting.
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More than three million people travel to undergo cosmetic surgery each year, statistics show — but the potential savings come at a cost.
Most people opting to pursue this so-called “medical tourism” are chasing budget-friendly price tags.
International surgeries, such as hair transplants in Turkey, can cost as little as $4,000 to $5,000 compared to $20,000 to $30,000 in the U.S., but often come with extreme risks, according to board-certified plastic surgeon Dr. Sheila Nazarian of California.
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The doctor recently joined Lisa Brady on the “The FOX News Rundown” podcast to discuss the rising trend of medical tourism. One of the biggest risks, she said, is the lack of safety regulations in popular destinations like Mexico and Turkey.
As demand spikes in these medical tourism “mills,” there have been reports of non-medically trained staff performing procedures like hair transplants.
Most people opting to pursue “medical tourism” are chasing budget-friendly price tags. (iStock)
“I’ve heard that they [international clinics] are even recruiting people who maybe were taxi drivers and then putting them through their own training program … to become hair transplant technicians,” Nazarian said. “That’s how high the demand has become.”
In the U.S., medical school graduates are granted a “physician and surgeon” license, which means doctors — including pediatricians or OB-GYNs — can legally perform cosmetic surgeries, even if they didn’t receive specialized training for those procedures during residency, Nazarian noted.
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Instead of pinching pennies, the doctor recommended paying whatever amount is necessary to ensure quality treatment.
“People think of it as, you know, going to the mall. … It’s surgery, and surgery has risks,” she said. “You need to be with someone who not only can perform a beautiful surgery, but who can handle possible complications well.”
“You need to ask them: ‘What was your residency training in? And if you wanted to, would you be allowed to do this procedure in a hospital?’”
Aftercare is another critical factor in the success and safety of a cosmetic procedure, as the doctor emphasized that 20% of a surgical result depends on post-operative care.
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This can be difficult or even impossible to manage when a doctor is in a different time zone, she cautioned, or if the clinic disappears shortly after the procedure.
Nazarian also noted the importance of addressing the psychological component of plastic surgery, noting that no procedure will fix underlying unhappiness. The doctor said she uses screening questionnaires to ensure that patients are truly seeking self-improvement rather than a “cure” for deeper issues.
International surgeries, such as hair transplants in Turkey, can cost as little as $4,000 to $5,000 compared to $20,000 to $30,000 in the U.S., but often come with extreme risks. (iStock)
“If you’re not already generally very content with your life, a knife in my hand is not going to bring you there,” Nazarian said.
“The analogy I always give is you don’t want a paisley couch — you want a neutral couch and you can put paisley pillows on it,” she said, noting that a procedure should “make you look normal, God-given, athletic. And then you can change your clothes when the trends come and go.”
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Samuel Golpanian, M.D., a double board-certified plastic surgeon in Beverly Hills, said he has also seen an increasing number of patients undergoing cosmetic procedures abroad, sometimes with “devastating consequences.”
“The key is being extremely careful before embarking on this journey.”
“I’ve seen a wide range of complications, including infections, poor wound healing, significant scarring and tissue necrosis (skin death),” he told Fox News Digital. “These complications often lead to prolonged pain, ongoing medical problems, and significant additional costs to repair the damage.”
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Golpanian said he’s treated patients who received unsafe or non-medical-grade injectable materials, which can lead to serious long-term health issues.
One surgeon said he’s treated patients who received unsafe or non-medical-grade injectable materials, which can lead to serious long-term health issues. (iStock)
“I’ve also seen damage to underlying structures, asymmetry and results that are extremely difficult — sometimes impossible — to correct.”
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“That said, I’ve also seen some good outcomes, so it’s not all bad,” he noted. “The key is being extremely careful before embarking on this journey.”
Quick tips for safe ‘medical tourism’
Fully vet the surgeon. “Most surgeons will provide information about their education and training, but it’s important not to accept these claims at face value,” Golpanian said. “Verify them directly by contacting the institutions where they trained.”
Ask for references from prior patients. Ideally, it’s best to get references from U.S.-based patients who can speak candidly about both their experience and their results, the surgeonsaid.
Think beyond the cost. Golpanian emphasized the adage “you get what you pay for.” “Cost should take a back seat to experience, training, judgment and proven results,” he advised.
Be cautious about relying on before-and-after photos. These can be selective or even enhanced, Golpanian warned.
Keep aftercare in focus. “Make sure the practice emphasizes comprehensive follow-up care and has a clear, realistic post-operative plan in place.”
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