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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The Trump administration is taking another look at ending biannual clock changes, with an eye toward making daylight saving time (DST), or the “summer clock,” permanent.
On May 21, the House Energy and Commerce Committee advanced legislation that would make daylight saving time permanent in a 48-1 vote, part of a largely bipartisan push to end twice-yearly clock changes.
Although gaining extra winter evening daylight might seem like a win, health experts say permanent daylight saving time could disrupt people’s natural circadian rhythms.
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In an interview with Fox News Digital, Dr. Wendy Troxel, a licensed clinical psychologist and senior behavioral scientist at RAND based in Utah, said science is being “misconstrued” in this decision.
“Ending the biannual clock change is something most sleep scientists and the public would welcome,” she said. “The disruption of springing forward every March is associated with real, measurable harm — spikes in car crashes, heart attacks and sleep deprivation.”
The Trump administration is taking another look at ending semiannual clock changes, with an eye toward making daylight saving time, or the “summer clock,” permanent. (iStock)
However, Troxel noted, implementing permanent daylight saving time is “not supported by science.” Instead, evidence “strongly supports” permanent standard time, or the “winter clock,” according to the expert.
Major sleep medicine organizations, including the American Academy of Sleep Medicine, have previously supported adopting permanent standard time over permanent daylight saving time.
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“Standard time is more closely aligned with human circadian biology, meaning the relationship between light, darkness and our internal clocks remains intact,” Troxel said.
“Permanent DST simply shifts an hour of morning sunlight to the evening, and there are significant health and safety costs of that trade.”
“Standard time is more closely aligned with human circadian biology,” the expert said. (iStock)
The U.S. attempted permanent DST in the early 1970s, but the plan was aborted in part due to these “morning consequences,” according to the sleep expert.
“Within a year, the law was repealed amid public displeasure with commuting to work and school in the dark and increases in morning car crashes, and with no demonstrable impact on energy savings,” Troxel told Fox News Digital.
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Human circadian rhythms are primarily “anchored” by morning light, Troxel said. Under permanent DST, most people waking up for work or school would be rising before the sun, which forces a “chronic misalignment between the body’s internal clock and the external world.”
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“You cannot override that biology by simply shifting external clocks forward,” the expert said. “What you get instead is a population that is effectively waking up in the middle of their biological night, every single day.”
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The public has typically supported having more daylight in winter evenings, which could alleviate mental health conditions such as seasonal depression.
Supporters of permanent daylight saving time argue that later evening daylight could encourage outdoor activity, recreation and consumer spending after work or school.
Morning light is “crucial to regulate sleep, [boost] alertness and support mental health,” according to a sleep expert. (iStock)
Troxel agreed that light is a “powerful regulator” for sleep and moods, but noted that not all types have the same benefits.
“Morning light is crucial to regulate sleep, alertness and support mental health, and this would be sacrificed with permanent daylight saving time,” she noted.
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In some areas of the country, like Utah, Americans wouldn’t see the sunrise until about 9 a.m. in the winter, which some research has linked to higher rates of depression and seasonal mood challenges.
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“More evening light may feel enjoyable, in part because we equate it with lovely summer evenings, but permanent daylight saving time does not mean permanent summer,” Troxel emphasized. “It just means we will get less morning sunlight and more evening sunlight.”
“Exposure to light in the evening further pushes circadian rhythms later, making it more difficult to fall asleep and harder to wake up in the morning.”
Risks for vulnerable groups
Permanent daylight saving time can intensify people’s habit of “bedtime procrastination,” deepen sleep deprivation and contribute to the widespread public health issue of insufficient sleep already identified by the Institute of Medicine, according to Troxel.
Teens are most at risk of mental health complications if permanent DST extends darkness in the morning. (iStock)
Various studies have shown that people typically sleep less in summer compared to winter. Troxel said this is particularly concerning in a society where one in three people are already getting insufficient shuteye.
“This is especially alarming for teenagers, a population the U.S. surgeon general has identified as being in a mental health crisis,” she cautioned.
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For example, a teen waking up at 6:30 a.m. for an 8 a.m. school start time under permanent DST would be rising biologically at 5:30 a.m., Troxel noted, which is “in the middle of their biological night.”
“Framing permanent DST as a fix for seasonal depression gets the science exactly backwards,” she added.
Fox News Digital’s Alex Nitzberg contributed to this report.
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People who quit smoking may reduce their risk of developing dementia later in life, according to new research.
A team of researchers at a university in China analyzed data from more than 32,000 adults over a 25-year period and found that former smokers had a lower risk of dementia compared to people who continued smoking.
The findings were published in the journal Neurology.
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During the study period, researchers documented 5,868 cases of dementia.
Participants who quit smoking during the study had a significantly lower risk of developing dementia than current smokers. Their risk was similar to people who had quit smoking before the study began and those who had never smoked.
New research suggests that quitting smoking may lower the chance of developing dementia later in life. (iStock)
The researchers also found that dementia risk continued to decline the longer a person remained smoke-free, approaching that of never-smokers after about seven years.
The benefits appeared strongest among people who gained little or no weight after quitting.
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“Our findings suggest that quitting smoking may support long-term brain health, but they also highlight that what happens after quitting matters,” lead researcher Hui Chen said in a statement.
The reduction in dementia risk was most pronounced among people who experienced little or no weight gain after they stopped smoking. (iStock)
Zaid Fadul, a Harvard-trained physician and chief medical officer of Bespoke Concierge MD who was not involved in the research, said the findings add to growing evidence that quitting smoking can help protect long-term brain health.
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“The key takeaway is that the brain appears to benefit from smoking cessation at virtually any stage,” Fadul told Fox News Digital.
“Smoking contributes to chronic inflammation, oxidative stress, and damage to blood vessels that supply the brain, all of which are associated with cognitive decline and dementia risk.”
Fadul said the findings should encourage smokers who may feel it is too late to quit.
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“Importantly, it is rarely ‘too late’ to quit,” he said.
“While earlier cessation offers the greatest benefit, the body and brain begin recovering soon after smoking stops.”
Experts say it is almost never too late to quit smoking, as the body and brain start to recover soon after a person stops, although quitting earlier provides the greatest health benefits. (iStock)
Improvements in circulation, reduced inflammation and better cardiovascular health can help preserve cognitive function later in life, according to Fadul.
“Every year without tobacco is a step toward lowering future dementia risk and improving overall health,” he said.
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While the findings were encouraging, the study does have limitations.
Researchers identified an association between quitting smoking and a lower risk of dementia, but the study was not designed to prove that ending smoking directly prevents the condition.
Other health, lifestyle and environmental factors may have also influenced participants’ outcomes.
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Fox News Digital reached out to the researchers for further comment.
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