Early detection is key in Alzheimer’s disease

Text Kari Salmela | Photo Raija Törrönen

Professor Miia Kivipelto became interested in memory disorders in upper secondary school, due to having to watch her grandmother slip away to Alzheimer’s.

Today, Professor Kivipelto is an internationally recognised Alzheimer’s researcher working at Karolinska Institutet in Stockholm and the University of Eastern Finland in Kuopio. Her research focuses on charting the risk factors and prevention possibilities of Alzheimer’s disease. She also studies the early detection and treatment possibilities of the disease.

”It has been demonstrated that Alzheimer’s disease may begin to develop already in early adulthood, long before any symptoms start to show. By the time the symptoms appear and the diagnosis can be confirmed, the disease is already at an advanced stage.”

”If we are able to develop and bring drugs onto the market that slow down or even stop the progression of the disease, the significance of early detection becomes increasingly important. Furthermore, all measures that slow down the disease and delay the need for institutional care also mean reduced costs in the public health care sector,” Professor Kivipelto points out.

An incurable disease

Researchers have worked hard to find efficient drugs to combat Alzheimer’s disease and there have been expectations of finding a cure. However, Professor Kivipelto sees this as a challenge requiring a lot of hard work.

”Given the complexity of Alzheimer’s disease, it’s unlikely that a single cure – be it a drug or a treatment – will be found. The more likely alternative is the adoption of varying combinations of drugs that have different mechanisms of action, which is something that has been used in the treatment of other chronic multifactorial diseases.”

Genetic heritage affects the risk for Alzheimer’s

The risk factors for Alzheimer’s disease have been charted in extensive studies conducted all over the world.

”The presence of the ApoE4 allele doubles or even triples the risk of Alzheimer’s disease. The risk is the same for people with a close relative with AD,” Professor Kivipelto says.

”It is likely that we’ll find other genes which contribute to the disease, but their exact role is still unknown. We have also found evidence of interaction between genetic and environmental factors, and it seems that the carriers of a risk gene, such as the ApoE4, are more susceptible to unhealthy lifestyle factors like low physical activity, frequent use of fatty foods, smoking and heavy misuse of alcohol as regards the risk for dementia.”

Lifestyle habits important for risk groups

According to recent estimates, approximately one-half of all AD cases are connected to risk factors related to lifestyle habits, e.g. low physical and mental activity, obesity, diabetes, high blood pressure, smoking, etc.

”From the viewpoint of AD prevention, this is good news.”

The prevention of Alzheimer’s disease is also a question of great financial importance.

”The population is aging rapidly and it is estimated that the number of patients diagnosed with AD will quadruple over the next fifty years. Being able to postpone the onset of the disease even for a bit would imply significant financial consequences.”

In the future, extensive prevention campaigns, early diagnosis and a combination of efficient drug and non-pharmacological treatments will play key roles in the battle against the disease.

PhD - a stepping stone to international career

Professor Kivipelto started her medical studies in Kuopio in 1992.

”Kuopio has a strong tradition in neuroscience research, and I participated in some research projects during my studies. I also spent a year as an exchange student at Karolinska Institutet, and it was during my clinical period there that I got the ultimate inspiration for memory research,” she explains.

Back in Kuopio, Professor Hilkka Soinen told her about an opportunity to take part in the population-based Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study.

”I found it extremely fascinating to be involved in a human-oriented study and to carry out research into the influenceable risk factors, which at the time constituted an entirely new field of research. I was excited about the project and I worked in it as a medical researcher and coordinator, and I defended my dissertation in 2002,” says Professor Kivipelto.

”The results of my doctoral dissertation attracted a lot of international attention and my career got off to a flying start. The famous Professor Bengt Winblad at Karolinska Institutet had read one of my articles and invited me there.”

For the University of Eastern Finland and Karolinska Institutet, this marked the beginning of fruitful cooperation, which has grown stronger and more and more extensive over the past few years.