Mayo Clinic develops breakthrough tool to predict Alzheimer’s risk years before symptoms appear

UAE—Mayo Clinic researchers have developed a groundbreaking tool that can estimate a person’s risk of developing memory and thinking problems associated with Alzheimer’s disease years before symptoms appear.

The research, published in The Lancet Neurology, builds on decades of data from the Mayo Clinic Study of Aging, one of the world’s most comprehensive population-based studies of brain health.

The study revealed that women face a higher lifetime risk than men of developing dementia and mild cognitive impairment (MCI), a transitional stage between healthy aging and dementia.

MCI often affects quality of life but still allows people to live independently.

Men and women who carry the common genetic variant APOE ε4 also face elevated lifetime risk for these conditions.

Understanding Alzheimer’s proteins

Alzheimer’s disease manifests through two key proteins in the brain: amyloid, which forms plaques, and tau, which forms tangles.

The Food and Drug Administration has recently approved drugs that remove amyloid from the brain and can slow the rate of disease progression for people with MCI or mild dementia.

Dr. Clifford Jack, Jr., a radiologist and lead author of the study, explained the significance of this advancement.

“What’s exciting now is that we’re looking even earlier—before symptoms begin—to see if we can predict who might be at greatest risk of developing cognitive problems in the future,” Dr. Jack stated.

New prediction model combines multiple risk factors

The new prediction model combines several factors, including age, sex, genetic risk associated with APOE genotype, and brain amyloid levels detected on PET scans.

Using this data, researchers can calculate an individual’s likelihood of developing MCI or dementia within 10 years or over their predicted lifetime.

Among all the predictors evaluated, brain amyloid levels detected on PET scans emerged as the predictor with the largest effect for lifetime risk of both MCI and dementia.

Dr. Ronald Petersen, a neurologist, director of the Mayo Clinic Study of Aging, and co-author of the study, highlighted the practical applications of this tool.

“This kind of risk estimate could eventually help people and their doctors decide when to begin therapy or make lifestyle changes that may delay the onset of symptoms. It’s similar to how cholesterol levels help predict heart attack risk,” Dr. Petersen noted.

Comprehensive population study ensures accuracy

The research stands apart because it draws from the Mayo Clinic Study of Aging, a long-running effort in Olmsted County, Minnesota, that tracks thousands of residents over time.

The analysis for this study included data from 5,858 participants.

Unlike most studies, Mayo researchers continue following participants even after they stop actively taking part, using medical record data to ensure nearly complete information about who develops cognitive decline or dementia.

Dr. Terry Therneau, who led the statistical analysis and serves as the senior author of the study, emphasized the unique value of this approach.

“This gives us a uniquely accurate picture of how Alzheimer’s unfolds in the community,” Dr. Therneau explained.

“We found that the incident rate of dementia was two times greater among the people who dropped out of the study than those who continued to participate.”

Advancing personalized care and early intervention

The study elevates the significance of MCI, which represents the stage targeted by current Alzheimer’s drugs that slow but do not stop disease progression.

While the new tool currently functions as a research instrument, it represents a major step toward more personalized care.

Future versions may incorporate blood-based biomarkers, which could make testing more accessible to a wider population.

The National Institute on Aging, the GHR Foundation, Gates Ventures, and the Alexander Family Foundation supported this work.

The research is part of a larger Mayo Clinic initiative called Precure, which focuses on developing tools that empower clinicians to predict and intercept biological processes before they evolve into disease or progress to complex, hard-to-treat conditions.

“Ultimately, our goal is to give people more time—time to plan, to act, and to live well before memory problems take hold,” Dr. Petersen concluded.