Doctors and patients often associate precursors of disease with physical symptoms; for example, a precursor of COPD may be a persistent cough, while precursors of breast cancer could be changes in breast shape or lingering pain. However, a new study challenges us to look outside the box when identifying these disease symptoms, and suggests that a precursor of Alzheimer’s may be as simple as increased loneliness.

The study, now published online in the journal JAMA Psychiatry, found that higher cortical amyloid levels, a pre-marker of Alzheimer’s disease, were associated with greater loneliness. For example, participants in an amyloid-positive group were 7.5 times more likely to be classified as lonely compared with individuals in the amyloid-negative group. This association remained even after the researchers controlled for age, sex, socioeconomic status, depression, anxiety and the size of someone's social network.

"We report a novel association of loneliness and cortical amyloid burden in cognitively normal adults and present evidence for loneliness as a neuropsychiatric symptom relevant to [undiagnosed Alzheimer's],” concluded the researchers, as reported in a recent press release. “This work will inform new research into the neurobiology of loneliness and other socioemotional changes in late life and may enhance early detection and intervention research in AD."

For their study, the team looked at the cortical amyloid levels of 43 women and 36 men (with an average age of 76). Of the group, 22 (28 percent) were carriers of the genetic risk factor for Alzheimer's and 25 (32 percent) were in the amyloid-positive group based on volume in their brain imaging. The participants' average loneliness score was 5.3 on a scale of 3 to 12. In addition to higher cortical amyloid levels being associated with greater loneliness, the team also observed that the association between these two factors was higher in participants with a genetic predisposition to Alzheimer's than it was for those without.

Alzheimer's disease is one of the top 10 leading causes of death in the United States, and death rates continue to increase as our population further ages, The Centers for Disease Control and Prevention report. Early diagnosis plays an important role in successfully treating the condition. Researchers hope studies like these will help doctors better identify the most at-risk members of the population and provide them with the intervention they need.

Source: Donovan N, Okereke OI, Vannini P. Association of Higher Cortical Amyloid Burden With Loneliness in Cognitively Normal Older Adults. JAMA Psychiatry . 2016

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