Finally – after many false dawns – an effective new drug for Alzheimer’s is on the horizon. In early May, US scientists announced that the drug donanemab delays the worsening of symptoms by 35 per cent. Half the patients on the trial found their mental decline was halted for more than a year.
The Alzheimer’s Society went as far as describing the results as: “the beginning of the end for Alzheimer’s disease”.
There a still few hurdles to jump before donanemab becomes available in the UK. But even when it does arrive, scientists insist that early diagnosis – by watching out for subtle symptoms – is still key.
In February, scientists announced a new blood test that could predict dementia up to 15 years earlier. The new test, the result of a study by the University of Warwick, looks for proteins in the blood and can pick up signs that the prescriptions of drugs such as donanemab – or lecanemab, a similar medication – would be appropriate.
It’s well known that memory loss and confusion are a sign of dementia. But scientists are discovering that other subtle – and perhaps surprising – signs can herald the onset of the disease. For example, in October, UCL researchers found that people who wandered off course walking on a well-known triangular route, might be showing early signs of dementia.
These smaller and quieter clues occur in our daily lives, making them fairly easy to identify – if you know what to look out for. With our senses being linked to the brain, it’s not surprising that occurrences, such as those relating to our eyesight or hearing, could be signs of early dementia.
However, it is also key to understand that some of these changes, such as mood or occasional moments of forgetfulness, can simply be signs of old age – which are not as concerning.
Read below for the quiet, early signs of dementia – and some advice on how to prevent their progression.
What signs and symptoms of dementia should you look out for?
Eye conditions and hearing loss
People who develop certain eye conditions are at increased risk of dementia, according to research from 2021. A UK Biobank study of 12,000 midlifers found those with age-related macular degeneration were 25 per cent more likely to develop dementia. Those with cataracts had an 11 per cent increased risk of dementia, and those with diabetes-related eye disease had a 61 per cent per cent heightened risk of dementia.
The study follows research from 2021 by the University of Oxford that suggested people who go out for a meal at a noisy restaurant but are unable to hear what their friends are saying may be at an increased risk of developing dementia. The data from the study suggests that age-related hearing loss might be related to the onset of Alzheimer’s and other conditions.
“While preliminary, these results suggest speech-in-noise hearing impairment could represent a promising target for dementia prevention,” says Thomas Littlejohns of the Nuffield Department of Population Health at Oxford and a lead author of the study.
Katie Puckering is information services manager for Alzheimer’s Research UK. “There are two reasons for this potential link,” she says. “The first is that hearing loss might be linked with cellular changes in the brain. But the second is that social isolation has long been known as a risk of Alzheimer’s and other forms of dementia.”
Something as simple as having your hearing checked out – and having a hearing aid fitted, if needed, so you can hear the conversations around you – could lower your risk of dementia. This is known as a modifiable risk – that is, one that you can change or control.
In 2017, the Lancet Commission on Dementia found that 12 modifiable risks – one being hearing loss – could lower the number of dementia cases by 40 per cent. Others included lack of physical activity, obesity and low educational attainment.
“Mild cognitive symptoms can begin 15 to 20 years before the onset of dementia,” says Puckering. “If it’s picked up early enough, a doctor can refer you to a memory clinic for further tests or point you in the direction of research trials.”
Breakthrough medical treatments are starting to appear, such as medications aducanumab and Lecenamab, which has been licensed in the US and is pending approval in the UK.
“Early intervention gives you the best chance,” says Puckering. “At the very least, this will allow you to plan ahead.”