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An Alzheimer's Warning 25 Years Before Symptoms Show

•, Karen Weintraub

The first detectable signs of Alzheimer's disease occur as long as a quarter century before symptoms like memory loss become noticeable, according to a detailed chronology of molecular changes to the brain and spinal fluid of people who later developed the brain disease.

The research, published today in the New England Journal of Medicine, provides a timeline of the subtle changes that begin in victims' brains and, importantly, can be detected years ahead of time by MRI exams, blood analyses, or other tests.

The development of biomarkers that can track and predict the natural course of the disease is important for carrying out drug studies, in part because changes to these molecules could give early hints that a drug works. Treatments for Alzheimer's have all been unsuccessful so far—in part, researchers think, because people received drugs only after symptoms had become obvious and their brains were too damaged to recover. 
"This is perhaps the most comprehensive picture of what changes, in what order, and by how much," says Randall Bateman, a professor of neurology at Washington University School of Medicine, and the study's first author.  

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