Eye-tracking test may help diagnose Alzheimer’s disease

Q: I’ve finally heard you have a test for Alzheimer’s disease, which has something to do with your eyes. What is it and how does it work?

A: Researchers are still looking for a single, definitive diagnostic test for Alzheimer’s disease, but at that time they have not reached that goal. However, they continue to make advances in this area, including recent studies suggesting that eye movement disorders may be predictive in some cases.

Although there is no cure for Alzheimer’s disease, early intervention is associated with better patient outcomes, including improved quality of life. Therefore, development that is useful for diagnosis is important.

As you probably know, Alzheimer’s disease is a progressive disease. Physical changes that occur in the brain gradually cause cognitive impairment and dementia. Although Alzheimer’s disease is most common in older people, it is not considered a normal part of aging. Symptoms include poor memory, thinking, speech, judgment, concentration, and ability to perform tasks. The disease can also change your mood and personality.

Other types of dementia and cognitive impairment share many of the same symptoms, making early diagnosis more difficult. Diagnosis of Alzheimer’s disease involves a variety of screening processes, including neurological tests, tests to assess cognitive and mental status, genetic tests, and brain imaging. For some patients in the early stages of their illness, careful waiting is part of the process and sometimes frustrating.

The study you are asking examines eye movement disorders as a diagnostic tool for at-risk patients. Participants with two different types of cognitive impairment were assigned visual tasks on a computer screen. For example, if you see a flashing icon on the right side, you were asked to look at the left side of the screen. A device capable of measuring 500 eye movements per second analyzed how well each person completed a task. The researchers found that the visual behavior of each group was unique enough that the test results alone could distinguish the two types of dementia.

Even more promising was the fact that the pattern of eye movements of one type of dementia, where people struggled to see the right side of the screen, was similar to what was diagnosed with Alzheimer’s disease.

The point here is that eyetracking shows that eye tracking can predict whether people with mild cognitive impairment are likely to develop Alzheimer’s disease. This means more patients can start treatment sooner than they are now, instead of waiting for progressive symptoms.

Without treatment for Alzheimer’s disease, patients rely on treatments developed to prolong and enhance independence and improve quality of life. These include memory training, mental stimulation, social integration and exercise programs. Cognitive therapies such as puzzles, simple number and arithmetic problems, and memory exercises have also been shown to benefit. All of these are most successful before Alzheimer’s disease becomes too advanced and early diagnosis becomes more important.

Q: My wife had a medical examination once a year and when she got back blood tests, she was said to have had a recent heart attack. What did she do because she had no symptoms?

A: Your wife had what is known as a “silent” heart attack. As the name implies, it’s a heart attack that goes unnoticed by a person. However, in many cases it turned out that the episode was not so quiet.

It’s true that he hasn’t experienced the numbness in his left arm or sudden chest pain that is familiar in movies and television. This is sometimes called a “Hollywood” heart attack. However, as a result of the review, many will find themselves aware of various subtle symptoms that indicate that a heart attack is occurring.

A heart attack occurs when something blocks the flow of blood to the heart. Without the oxygen and nutrients supplied by the network of blood vessels known as the coronary arteries, the heart muscle begins to die. This causes various symptoms. The most commonly known symptoms of a heart attack are chest pain and pressure, pain in one or both arms or discomfort. Other symptoms include pain or discomfort in the neck, jaw, back, or stomach. Nausea, lightheadedness, dizziness, shortness of breath, sudden sweating, tiredness. These can be very gentle, concise, and even harmless, who never ties them to a heart attack.

Studies show that asymptomatic heart attacks are more common in women than men. Women are also more likely to experience symptoms unrelated to chest pain. People who have had a quiet heart attack may later experience dizziness and shortness of breath, stomach pain and nausea, and neck pain and unusual fatigue. These symptoms may be due to other causes such as flu, stress, indigestion, and muscle tension. However, as with your wife, blood tests reveal elevated levels of a protein called Troponin T or Troponin I. These are released into the blood when the heart muscle is damaged.

The risk factors for any type of heart attack are the same. This includes previous heart attacks, family history of heart disease, tobacco product use, high blood pressure, high blood cholesterol, overweight, lack of diet, lack of exercise, and more. Age and race also play a role.

After someone has a heart attack, they can change their lifestyle to a lower risk. These include quitting smoking, reaching and maintaining a healthy weight, and adopting a healthy diet. Managing chronic health conditions such as diabetes; and becoming physically active. When appropriate, medications that control high blood pressure and high blood cholesterol are prescribed.

If someone has symptoms of a silent heart attack, it is important not to ignore them. Early treatment not only reduces the damage to the heart, but also saves lives.

• Dr. Eve Glazier is a Physician and Associate Professor at UCLA Health. Dr. Elizabeth Ko is a physician and associate professor at UCLA Health. Please send any questions to [email protected].