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Poor sense of direction? You could have Alzheimer’s, study suggests
Having a poor sense of direction could be an early warning sign of Alzheimer’s, a study suggests.
Data from an ongoing trial by University College London (UCL) show that people at risk of the disease have poor spatial navigation before other early problems, such as memory issues, emerge.
It is hoped the findings might lead to the development of a diagnostic support tool for the NHS.
The research used virtual reality to test the ability of 100 asymptomatic adults aged 43 to 66 to determine and maintain a route from one place to another.
Participants were high-risk for Alzheimer’s, such as having the APOE-4 gene, a family history or a poor lifestyle.
The researchers found the relationship between spatial skills and Alzheimer’s risk in men, but not women.
The findings suggest impairments in spatial navigation may begin to develop years, or even decades, before the onset of any other symptoms, the experts say.
“Our results indicated that this type of navigation behaviour change might represent the very earliest diagnostic signal in the Alzheimer’s disease continuum – when people move from being unimpaired to showing manifestation of the disease,” said study author Dr Coco Newton, from UCL, who carried out the work while at the University of Cambridge.
The study used a test in which people were asked to navigate within a virtual environment while wearing VR headsets.
Dr Newton added: “We are now taking these findings forward to develop a diagnostic clinical decision support tool for the NHS in the coming years, which is a completely new way of approaching diagnostics and will hopefully help people to get a more timely and accurate diagnosis.
“This is particularly important with the emergence of anti-amyloid treatments for Alzheimer’s, which are considered to be most effective in the earliest stages of the disease.
“It also highlights the need for further study of the differing vulnerability of men and women to Alzheimer’s disease and the importance of taking gender into account for both diagnosis and future treatment.”
One in three develop dementia
Dr Richard Oakley, associate director of research and innovation at Alzheimer’s Society, said: “One in three people born today will go on to develop dementia, and early and accurate diagnosis of the diseases that cause the condition are vital for people to access the right support, plan for the future, and receive appropriate treatment.
“Very early symptoms of dementia can be subtle and difficult to detect, but problems with navigation are thought to be some of the first changes in Alzheimer’s disease.”
He added: “More work is needed to develop this technology, but it will be exciting to see how this research may offer a way to spot disease-specific changes early and help people living with dementia in future.”
The study is published in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association.
注释：
manifestation: n
表示" 表现"，means "a manifest indication of the existence or presence or nature of some person or thing"，如：She noticed this slight hint of manifestation of the colour bar. 她注意到了这个微小的种族歧视的表现。This riot is only one manifestation of people's discontent. 这骚乱仅仅是人们不满的一种表露而已。
中文简要说明：
英国伦敦大学学院研究团队近日发表的研究成果显示，即使尚未出现记忆力问题等其他较常见的征兆，中年人的方向感变差或空间移动能力衰退，几年后罹患阿兹海默症的风险比较高，而且这种倾向在男性受试者身上比较明显，应审慎看待。研究团队希望这项发现能促进诊断工具的发展。
英国《电讯报》、美国《每日健康新闻》（HealthDay News）报导，英国伦敦大学学院（University College London，UCL）正在进行的一项研究数据显示，有罹患阿兹海默症风险的中年人，可能出现方向感减退的症状，这种自我导航能力变差的问题，发生的时间点恐怕会比其他典型罹病症状早好几年甚至几十年，称得上是非常早期的征兆。
研究团队招募100名43岁至66岁受试者参与实验，这100人并无失智症状但属于阿兹海默症高风险族群，例如带有APOE-4基因、有家族病史、生活方式较不健康等等，受试时的年龄都比预期发病岁数年轻25岁。
受试者使用虚拟现实（VR）头戴式装置，在虚拟环境测试方向感。实测结果显示，高患病风险、在其他认知测试得分较高者，即使没有其他先期症状，在VR测试的表现较差，而且这种倾向在男性受试者身上比女性明显。现阶段的结论表明，在方向判断、复杂空间移动时发生困难，可能是失智的预兆。
研究报告作者是UCL的纽顿（Coco Newton），她在剑桥大学期间就开始这项研究。纽顿说，方向感行为变化可能代表阿兹海默症连续性质表现之中极为早期的诊断讯号，患者在没有其他官能衰损的情况下可能由此展现进入病程的征象。至于这项研究的性别差异也是一大特点，她强调，未来需要进一步研究男女罹病弱点的不同，病情诊断与后续治疗是否纳入性别考虑是否也很重要。
研究团队指出，实验过程使用的VR测试，有朝一日可能成为评估阿兹海默症罹病风险的全新标准工具。研究成果已见刊于阿兹海默症协会期刊《阿尔兹海默症与失智症》（Alzheimer's and Dementia）。
英国阿兹海默症学会（Alzheimer's Society）研究与创新部门主任欧克利（Richard Oakley）认为，此症早期症状往往微乎其微、难以辨识，但方向感的确是最初期的变化之一，这个时代出生的人们有3分之1将来会罹患失智症，临床早期准确诊断至关重要，上述研究确实为阿兹海默症先期症状提供更多与方向感有关的证据，令人振奋，不过VR测试技术要能成为临床诊断工具，还有一段很长的路要走。
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