Alzheimer’s disease can be detected at an early stage through a simple and inexpensive analysis of urine samples, a study has found. Researchers of China found that formic acid – a chemical best known for its use in the sprayed venom of ant species, but which can occur naturally in the human body – can be found in significantly higher concentrations in the urine of people with Alzheimer’s disease, regardless of the severity of the disease. The discovery could pave the way for large-scale screening programs that could help detect the disease early enough to treat it before it occurs. irreversible.
According to the Alzheimer’s Society, there were more than 850,000 people in the UK with dementia in 2019 – equivalent to around 1 in 14 adults aged 65 and over.
They said: “If current trends continue and no action is taken, the number of people living with dementia in the UK is expected to increase to 1,000,000 by 2025 and 1,590,000 by 2040.”
The new study was conducted by gerontologist Yifan Wang of Shanghai Jiao Tong University and colleagues from WuXi Diagnostics Innovation Research Institute and Fudan University in Shanghai and Chinese Academy of Sciences in Beijing.
They said: “Alzheimer’s disease is an ongoing and hidden chronic disease, meaning it can progress and persist for many years before obvious cognitive impairment emerges.
The researchers continued, “The early stages of the disease occur before the stage of irreversible dementia, and this is the golden window for intervention and treatment. Therefore, large-scale screening for early-stage Alzheimer’s disease is necessary for the elderly.”
The problem with screening for Alzheimer’s disease is that the diagnostic methods doctors currently use are often expensive and difficult to apply. For example, one approach relies on brain imaging via so-called positron emission tomography (PET) – but these are costly and require patients to be exposed to radiation during the scan.
In contrast, tests that use biomarkers usually rely on the patient providing a sample of blood or, even worse, a sample of cerebrospinal fluid obtained via lumbar puncture. Both procedures can be unpleasant for patients.
Urine samples, on the other hand, are non-invasive and easy to deliver, making them well suited for large-scale screening programs. Although experts have previously identified urine biomarkers for Alzheimer’s disease, none have been able to reveal the disease at an early stage.
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In fact, the research built on earlier work by the same team that focused on the organic compound formaldehyde as a urine biomarker for Alzheimer’s disease. Formaldehyde which is perhaps best known for its use as a tissue preservative, but is also produced naturally in the body in small amounts.
Looking for a marker more effective at detecting early-stage Alzheimer’s, the team turned to formic acid, a metabolic product of formaldehyde.
To this end, the team recruited a total of 574 people who were early healthy volunteers with normal cognition or individuals with Alzheimer’s disease with varying degrees of progression – ranging from subjective cognitive decline to full-blown disease.
Each participant was subjected to a series of psychological evaluations and also donated blood and urine samples for analysis.
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Mr. Wang and colleagues found that, compared to the healthy control participants, all subjects with Alzheimer’s disease – including those with only early-stage subjective cognitive decline – had significantly higher levels of formic acid in their urine.
While the exact nature of the link between Alzheimer’s disease and formic acid is unclear, the researchers said, it appears the compound has potential as a biomarker for the disease, even in its early stages.
In addition, the team also found that when they compared urine formic acid levels with blood-based biomarkers for Alzheimer’s disease, they could more accurately predict the stage of the disease the patient in question was in.
The researchers concluded, “Uric acid showed excellent sensitivity for early screening for Alzheimer’s disease. The detection of urinary biomarkers of Alzheimer’s disease is convenient and cost-effective and should be performed during routine physical examination of the elderly.”
The full findings of the study have been published in the journal Frontiers in aging neuroscience.