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Anthea Rowan

This is the 21st instalment in a series on dementia, including the research into its causes and treatment, advice for carers, and stories of hope.
In July, Cognitact, a biotech start-up at The Hong Kong University of Science and Technology, launched PlasmarkAD, a blood test for early detection of Alzheimer’s disease (AD).
The same month, US-based Quest introduced the first-to-market consumer-initiated blood test for AD risk assessment.
Both are blood-based biomarker tests.
‘Sepia galactic storms’: Alzheimer’s amyloid plaques and tau tangles
PlasmarkAD is a “groundbreaking” approach that goes beyond traditional biomarkers, says professor Amy Fu Kit-yu, from Cognitact’s team.
She explains that it uses blood-based protein biomarkers to detect and assess the processes associated with the disease, including, for example, neurodegeneration, inflammation and vascular functions.
By analysing the levels of 21 plasma proteins, the test “captures the dysregulation of various biological processes and provides a comprehensive assessment of AD progression and severity”.

Quest’s test measures two peptides of amyloid protein; a lower ratio of one to the other in the brain is associated with a greater risk of developing Alzheimer’s disease.
These tests are a hopeful sign. They indicate that the science around this dreadful illness keeps moving forward. They also deliver an easier, less invasive and more cost-effective way to help form a diagnosis for AD.
Until now, diagnosis relied on costly MRI scans and time-consuming in-clinic cognitive tests, which can be unreliable. A patient may underperform if they are tired or feel nervous in a clinical setting, or they may disguise their limitations because they have learned to.

Timothy Kwok, a professor of geriatric medicine at the Chinese University of Hong Kong, describes a major advantage of the plasma test: it can detect early changes, before the onset of dementia, and even before brain atrophy changes can be seen on MRI scans.
It’s not just useful to confirm an AD diagnosis in those with dementia; it may also be useful in people with mild cognitive impairment, he says.
Another big advantage of a plasma test is that it assesses the contribution of different pathological brain changes, whether they are vascular or inflammatory or to do with immunity, Kwok says.

That means there’s a chance to change things – which leads to a more “personalised approach”.
I’m anxious because knowing what I know about dementia, and being the daughter of an Alzheimer’s sufferer, I wonder if I ought to be tested.
Fu says PlasmarkAD is recommended for individuals with subjective memory complaints, those with a family history of AD, and individuals who are in middle age. (I check two of those boxes.)
As ageing is the primary risk factor for AD and dementia, Fu says, “undergoing this test during middle age can provide a baseline understanding of one’s brain-health status”.

According to the Alzheimer’s Association in the US, most people – up to 99 per cent – do not carry a genetic mutation for the disease. You may, however, carry a copy of the APOE-e4 gene, and people who do may bear an increased risk of developing Alzheimer’s.
The key word is risk. Lack of physical exercise is also a risk, as is smoking, excessive alcohol and isolation, among many others.
Dr David Merrill, an adult and geriatric psychiatrist and director of the Pacific Brain Health Centre at California’s Pacific Neuroscience Institute, agrees that blood tests may be more accurate at pointing to a diagnosis than taking medical histories alone.
But Merrill has concerns, some of which speak to my anxiety.
“What support will be in place for newly diagnosed patients?” he asks. “The diagnosis of Alzheimer’s can be a devastating moment.”
Know your family medical history: your health could depend on it
The brain changes associated with Alzheimer’s can manifest years before any symptoms present – and in some people, even in the face of pathological changes, symptoms never present.
“I think that pathology testing [for the proteins amyloid and tau] needs to be done as part of a larger framework of looking at neurodegenerative disease risk,” Merrill says.
Then, if the results point to the “protein misfolding” that is characteristic of Alzheimer’s, “it may be reasonable to check to see if you have something brewing”.
No cure for Alzheimer’s, but we can narrow the odds of developing it
If you do, you can start intervening in ways that have scientifically based mechanisms for addressing the problems.
Therefore, Merrill says, early testing before symptom onset could make sense within the context of knowing that the information can inform which interventions to prioritise.
Quest is careful to warn that its test – the AD Detect Test for Alzheimer’s Disease – is not a direct-to-consumer test and nor is it “diagnostic”. It can only be ordered for those patients who meet certain other risk criteria – including a family history of AD, evidence of mild cognitive impairment or head injury. They aren’t eligible for testing if they don’t.
And that’s a good thing – almost half of those who never exhibit any cognitive decline actually die with amyloid on their brains.
Dementia can’t be cured so why get a brain scan to check for it? Here’s why
Would I get a test – given my mother had Alzheimer’s and I’m hurtling towards 60? No. I wouldn’t.
There is no cure for this disease, and a result that suggested I was at risk would cause undue stress.
I’m already doing everything I can to alleviate as much risk as I can. I also keep an eye on other test results – for cholesterol, blood pressure and blood sugar – all of which play into dementia risk as well.
If at any point I become concerned about my cognitive function, then, and only then, would I seek a blood test for Alzheimer’s to open a window of opportunity for interventions that may slow its development.
Like what you read? Follow SCMP Lifestyle on Facebook, Twitter and Instagram. You can also sign up for our eNewsletter here.


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Wellness

At risk for Alzheimer’s disease? 2 new blood tests could detect it early – here’s how they do it

New blood tests developed in Hong Kong and the US deliver an easier, less invasive and more cost-effective way to detect Alzheimer’s disease early. Photo: Shutterstock

Professor Amy Fu is on the Cognitact team at The Hong Kong University of Science and Technology. Photo: Professor Amy Fu

Previously, Alzheimer’s disease diagnosis relied on costly MRI scans. Photo: Shutterstock

Simulated results of Quest’s AD Detect Test for Alzheimer’s Disease. Photo: Quest

The author, Anthea Rowan, pictured with her late mother, who suffered from Alzheimer’s disease. Photo: Courtesy of Anthea Rowan

How your sense of smell is closely linked to your memory, and how you can fine-tune it to improve your memory and thinking

Actively sniffing out scents in nature can help bolster your sense of smell. Photo: Shutterstock


Our sense of smell is deeply entwined with our memory, and recent research shows it is possible to actually improve memory and cognition by exercising our sense of smell, in nature and elsewhere. Photo: Shutterstock

The olfactory bulb, which manages our sense of smell, sits at the bottom of the cerebral hemisphere near the front of the brain. Illustration: Shutterstock 

Michael Leon, professor of neurobiology and behaviour at University of California Irvine, published research showing how boosting the sense of smell can improve cognition. Photo: University of California Irvine

Cynthia Woo was a member of Leon’s team. Photo: University of California Irvine

Unlike vision changes which we manage with glasses, and hearing impairment with hearing aids, “there has been no intervention for the loss of smell”, says Professor Michael Yassa. Photo: University of California Irvine

Protect your head and safeguard your ability to smell. Photo: Shutterstock

Actively sniffing out scents in nature can help bolster your sense of smell. Photo: Shutterstock 

A bowl of fortified granola containing vitamin B12 with healthful seeds and nuts - a good source of zinc. A lack of certain nutrients, including zinc and vitamin B12, has been linked to a loss of smell. Photo: Shutterstock

Keep well hydrated: a dry mouth affects your sense of smell. Photo: Shutterstock

Quitting smoking will improve your sense of smell. Photo: Shutterstock

Avoid coffee, onions, garlic and other strong scents, and notice how your sense of smell comes back. Photo: Shutterstock

How can you prevent dementia? Free brain health online tool teaches the risks and gives essential tips on avoiding it

The new free “Think Brain Health Check-in” online tool from Alzheimer’s Research UK doesn’t test your memory but checks how well you’re looking after your brain and gives tips to help prevent dementia. Photo: Shutterstock

Dr Susan Mitchell is head of policy at Alzheimer’s Research UK. Photo: Dr Susan Mitchell

The Think Brain Health Check-in asks how often you challenge your brain - and then highlights why challenging your brain is key to staving off dementia. Photo: Shutterstock

Getting a good night’s sleep every night is one way to lower the risk of developing dementia. Photo: Shutterstock

Up to 40 per cent of dementia cases could be prevented if people were mindful of the risk factors for the illness and made lifestyle changes to prevent them. Photo: Shutterstock

Why B vitamins are essential for well-being, signs of vitamin B deficiency, and the foods to eat and supplements to take to avoid that, according to experts

Vitamin B complex is an option for people who don’t get enough of it through their diet. Photo: Shutterstock

Vitamin B deficiency may leave us with mental and physical fatigue. We look at warning signs you’re not getting enough B vitamins, and foods and supplements that contain them. Photo: Shutterstock

Cyrus Luk, a dietitian and executive committee member of the Hong Kong Dietitians’ Association. Photo: Cyrus Luk

For women, having enough vitamin B9 is especially important before and during pregnancy; it reduces the risk of birth defects of the brain and spine. Photo: Shutterstock

Vanita Rahman, a US-based internal medicine and lifestyle medicine physician and nutritionist. Photo: Barnard Medical Center

Those who drink too much alcohol may be at higher risk of having a vitamin B deficiency. Photo: Shutterstock

Many foods are fortified with added B vitamins – including B12 – such as cereals, breads, and pasta. Photo: Shutterstock

The floating duckweed plant, also known as water lentil, was recently discovered to be high in vitamin B12. Photo: Shutterstock

Lifestyle

Health & Wellness

Health

Family & Relationships

Decoding dementia

How caring for a parent with dementia taught me about symptoms, prevention and why seeking out the latest research is so important

Author Anthea Rowan (right) with her mother.

Author Anthea Rowan (right) with her mother, who has Alzheimer’s disease, the most common type of dementia. Photo: Anthea Rowan

Anthea with her mother. Photo: Anthea Rowan

Studies suggest that regular exercise lowers the risk of cognitive decline by 35 per cent. Photo: Getty Images

Staying active can help prevent or delay the onset of dementia, studies suggest. Photo: Shutterstock

Why should you have a brain scan to test for dementia when there’s no cure? Knowing can help you delay its onset, neurologist says

It can be daunting to get a brain scan to test for signs of dementia, but a neurologist behind new research reveals the advantages of knowing early. Photo: Shutterstock

New research has found that dementia can be detected as early as nine years before symptoms manifest, and this could have significant implications for treatment. Photo: Shutterstock

Timothy Rittman, the neurologist who led the dementia research at Cambridge University. Photo: Cambridge University

A brain scan showing signs of dementia. Photo: Getty Images

Lizzie Perry, founder of This is Dementia, with her father, who was diagnosed with the disease at 58. Photo: This is Dementia

The approval in the US of a new drug that slows the onset of Alzheimer’s makes Rittman hopeful about the future of dementia treatment. Photo: Cambridge University

Why women are more likely to have dementia than men as they age, and how exercise and engagement can help lower your risk

Women may be at a greater risk of developing Alzheimer’s than men for a number of reasons: biological, societal or cultural. Experts suggest exercise and social engagement can help offset the risk. Photo: Getty Images

The spread of tau – the protein that clumps into the telltale tangles of dementia – may contribute to Alzheimer’s disease. Photo: Shutterstock

Female twins with a male co-twin were less likely to be diagnosed with dementia than female twins with a female co-twin. Photo: Shutterstock

Prenatal care and monitoring pregnant women’s health is key, as it may impact cognition and dementia risk in later life. Photo: Shutterstock

Taking regular exercise is key for women – and men – to reduce the risk of dementia. Photo: Shutterstock

How high or low blood pressure increases the risk of dementia, and why it’s never too late, or early, to adopt a healthy lifestyle to manage it

Having blood pressure that is too high or too low has been linked to a higher risk of dementia, but it’s never too late to start living a healthy lifestyle that will help maintain optimal blood pressure. Photo: Shutterstock


An optimal blood pressure reading, easily measured with a home device, is around 120/80. Photo: Shutterstock

Dr Ruth Peters was lead author of a study looking at the links between blood pressure and dementia. Photo: Dr Ruth Peters

It’s never too late, or too early, to start thinking about brain health and living a healthy lifestyle. Photo: Shutterstock

Problems with reasoning, planning, judgment, memory and other thought processes may result from damage caused by impaired blood flow to the brain – which may be brought on by high blood pressure. Photo: Shutterstock

6 dementia fighting tips from Dr Sanjay Gupta and Marc Milstein, experts on brain health – walk, talk, read, learn, relax, and eat and drink properly

We can protect ourselves against the risk of dementia with some simple lifestyle practices. Exercising (above), eating a good diet, drinking less alcohol, socialising, reading more and trying new things all help keep the brain sharp, say brain experts including Dr Sanjay Gupta. Photo: Shutterstock 

The cover of one of Dr Sanjay Gupta’s book. Photo: Simon & Schuster

The cover of Marc Milstein’s book. Photo: Marc Milstein

Drink alcohol mindfully and ask yourself why you are having that drink. Photo: Shutterstock

Learning new things creates new brain cell connections and helps keep your mind sharp. Photo: Shutterstock

Reading is good for brain health. Try to read a wide range of book styles, and join a book club to discuss with others what you are reading. Photo: Shutterstock

During sleep, our brains are restored and repaired, so relaxing is important if we’re going to get those seven hours of quality sleep. Photo: Shutterstock

Relationships keep us engaged, interested and interesting, and may help prevent dementia. Photo: Shutterstock

‘Like a light switch’: how sundowning syndrome affects dementia sufferers – and their carers; what it is and tips for how to cope

A person with dementia may experience “sundowning” syndrome - towards the end of the day they become more agitated, confused, panicked, resistant to instruction and restless. This affects their carers, too. Photo: Shutterstock

A person in bed, unable to sleep. Conservative estimates suggest about 20 per cent of dementia patients experience sundowning at some point.

Trey Todd is a neuroscientist at the University of Wyoming. Photo: Trey Todd

Sundowning was coined in 1987 by Lois Evans of Penn Nursing at Pennsylvania University. Photo: University of Pennsylvania

The pineal gland in our brain produces melatonin, which is what helps prompt us to sleep and awaken. In a broken system it is disrupted. Melatonin supplements might help fight sundowning. Photo: Shutterstock

Taking a patient with sundowning syndrome for a walk at a consistent time each day, morning or evening, may alleviate symptoms. Photo: Shutterstock

Getting out into the daylight early in the day is good for our sleep patterns, whether we have dementia or not. Photo: Shutterstock

Healthy marriage, healthy mind? Dementia risk lower for people married a long time, studies show; expert suggests why

Research suggests that people who have stayed married for a long time have a lower risk for dementia because they feel less lonely, are more likely to eat well and exercise more, and are more cognitively engaged. Photo: Shutterstock

Vegard Skirbekk is a researcher at the Norwegian Institute of Public Health. Photo: Norwegian Institute of Public Health

Anthea Rowan’s parents on their wedding day. Photo: courtesy of Anthea Rowan

A long-time married partner represents a security that provides a buffer against stressors. Photo: Shutterstock

Anthea Rowan and her husband on their wedding day. Photo: courtesy of Anthea Rowan

If you live with a partner long term, you are more likely to develop healthy daily patterns, to eat well and exercise more. Photo: Shutterstock

‘Dementia village’ that’s the first of its kind helps residents live normal lives, has a restaurant, theatre and supermarket – and no one wears a white coat

Residents are free to live their lives as they like at the world’s first “dementia village”, The Hogeweyk in The Netherlands. Photo: The Hogeweyk

The Hogeweyk, a “dementia villlage” in the Netherlands, provides care and a familiar and safe environment in which people with dementia live while retaining their own identity and autonomy as much as possible. Photo: The Hogeweyk

Jannette Spiering is the senior managing adviser and co-founder at The Hogeweyk in the Netherlands, which offers “humanising care for people with dementia”. Photo: The Hogeweyk

Residents relax around the fountain in the theatre square at The Hogeweyk. Photo: The Hogeweyk 

Residents of The Hogeweyk respond positively to their increased autonomy. Photo: The Hogeweyk

Residents at the healthcare facility take part in a painting class. Photo: The Hogeweyk

Hearing loss dramatically raises the risk of dementia, so why are so many people in midlife doing nothing to prevent it? A test is easy to arrange

Hearing loss has been linked to a higher risk of dementia and cognitive decline,  say experts, who recommend testing for preventable hearing problems (above).  Photo: Getty Images

Alison Huang, a senior research associate at the Cochlear Centre at Johns Hopkins, in the US, says hearing loss makes the brain work harder to process sounds. Photo: Johns Hopkins

Jiang Fan from the School of Public Health at China’s Shandong University. Photo: Shandong University

Checking your hearing in midlife is crucial, and can help you stave off cognitive deterioration. Photo: Shutterstock

Can HRT reduce dementia risk? New hormone replacement therapy studies say yes, upending 2002 reports

HRT use has been linked to better cognition, blood flow and brain size and a reduction in all neurodegenerative disease in recent studies. Photo: Shutterstock

HRT (hormone replacement therapy) use has been linked to better cognition, blood flow and brain size and a reduction in dementia and other neurodegenerative disease in recent studies. Photo: Shutterstock

If HRT is started after the age of 65, brain cells will have already been deprived of oestrogen for many years. This could mean there is a decline in neuronal connections – the brain’s messaging system. Photo: Shutterstock

HRT was found to be most effective when introduced early in menopause, says Anne Marie Minihane, director of the UK’s Norwich Institute of Healthy Ageing at the University of East Anglia. Photo: University of East Anglia

Dr Andrea Kwakowsky from at the University of Galway in Ireland believes the “critical period” for starting HRT is within five years of menopause. Photo: University of Galway

Can lack of sleep raise dementia risk? Yes, studies say – but with one exception

Having only five hours of sleep a night can increase dementia risk by 30 per cent for adults over 50, one study says. Photo: Shutterstock

One tip to overcome insomnia is to avoid clock-watching. Photo: Shutterstock

Taking a warm shower or bath in the hour or so before bed may help you fall asleep – and stay asleep. Photo: Shutterstock

Professor Roger Wong of the department of public health and preventive medicine at the State University of New York’s Upstate Medical University. Photo: Roger Wong

Sleep aids can heighten dementia risk, Wong says. Photo: Shutterstock

Can’t sleep? Try getting up and engaging in cognitively stimulating activities, like reading or making jam. Photo: Shutterstock

Dementia and ACB scores: how common prescription and over-the-counter drugs raise the risk of memory loss and cognitive decline

Certain common drugs, including antihistamines, antacids, antidepressants and anti-anxiety medicines, can disrupt the neurotransmitter acetylcholine, dubbed the “memory molecule” increasing the risk of dementia. Photo: Shutterstock

The writer, Anthea Rowan, with her mother. Photo: Anthea Rowan

Taking medications that block the action of acetylcholine can lead to memory loss, problems with spatial awareness, and cognitive decline. Photo: Shutterstock

Studies have found that anticholinergic drugs carried “significant’ dementia risk” for the over-65s. Photo: Shutterstock

Doctors need to be mindful of the risks posed by anticholinergic drugs, especially to an already at-risk population: the over 65s. Photo: Shutterstock

How to safeguard your ageing brain: build ‘cognitive reserve’ with mental and physical exercise, and stay active and socially engaged

The phrase ‘use it or lose it’ is not just a hypothesis, it’s a basic biological fact that holds as true for our brains as our muscles or bones. Photo:
Shutterstock

Our brains, like our muscles need regular use to stay healthy and flexible, say experts, and keeping our brains active builds our ‘cognitive reserve’, helping us to stave off dementia. Photo: Shutterstock

Geriatric psychiatrist Dr David Merrill recommends the active pursuit of activities that keep the brain sharp to stave off dementia. Photo: Dr David Merrill

Dorina Cadar says cultural and social engagement, reading, doing crossword puzzles, visiting art galleries, clubs and cinemas, and volunteering all increase our cognitive reserve. Photo: Dorina Cadar

Visiting an art gallery or doing something new and different are good ways to build up cognitive reserve. Photo: Shutterstock 

How yoga benefits dementia patients: new study uncovers brain-health boosts, supporting earlier research

Yoga has health benefits including better brain neuroplasticity, improved sleep quality, and more robust cardiorespiratory fitness, all of which help people experiencing cognitive decline or dementia. Photo: Shutterstock

Dr Diana Karamacoska is a research support programme fellow in healthy ageing and dementia at the NICM Health Research Institute at Western Sydney University. Photo: Courtesy of Diana Karamacoska

Yoga could be helpful in managing brain inflammation, particularly with its mindfulness component. Photo: Shutterstock

Wendy Du is the founder of Shan Studios in Hong Kong. Photo: Wendy Du/Shan Studios

Du has maintained a daily yoga practice for 10 years. Photo: Courtesy of Shan Studios

5 nutrients good for brain health that can delay dementia, or prevent it, and foods to eat with a high concentration of them