A urine test could in the future reveal if people have early-stage Alzheimer’s.
The simple test can identify people with memory problems and Alzheimer’s based on the level of formic acid in their urine, a study has found.
Urine and blood tests are the major hope for one day screening people for early signs of dementia, as is currently done for early cancer.
CT and PET scans of the brain are expensive and expose people to radiation, while spinal taps to look for clues in spinal fluid are uncomfortable and invasive.
The simple test can identify people with memory problems and Alzheimer’s based on the level of formic acid in their urine, a study has found
However, while urine and blood tests are quicker and more straightforward, more research is needed on how well they work.
Now a study of almost 600 people suggests a high amount of formic acid in urine can be a warning sign of Alzheimer’s.
Researchers split 574 people into five groups, including those with normal thinking skills, people experiencing cognitive decline and those with more serious cognitive impairment.
The fourth group included people with ‘mild cognitive impairment’ — a clinical diagnosis which can lead to Alzheimer’s, while the fifth group already had Alzheimer’s.
Formic acid was higher among people in every single group with Alzheimer’s or cognitive problems, when compared to those with normal thinking skills.
Formic acid is produced in the body from formaldehyde, which at high levels in the brain may lead to clumps of harmful proteins seen in people with Alzheimer’s.
Researchers believe it may be a red flag for Alzheimer’s which can be used with blood tests to detect the condition.
Sian Gregory, research information manager at Alzheimer’s Society, said: ‘This is an exciting discovery as it offers a potential new way of detecting Alzheimer’s disease, that is less invasive and more cost-effective than current methods of diagnosing the disease.
‘This has never been more important, with diagnosis rates for dementia at a five year low.
‘However, this research is at an early stage and the study was fairly small.
‘We’re keen for more research to understand how Alzheimer’s disease might increase levels of formic acid in urine.’
The study, published in the journal Frontiers in Aging Neuroscience, suggests looking for formic acid in urine works better than blood tests for some proteins linked to Alzheimer’s.
The urine test results were linked to memory tests of people in the study, with higher levels of formic acid on average in people who performed worse in the tests.
These clues of the disease in blood and urine are known as biomarkers.
The researchers, led by Shanghai Jiao Tong University Affiliated Sixth People’s Hospital in China, say: ‘Our study revealed the possibility of urinary formic acid as a potential novel biomarker for the early diagnosis of Alzheimer’s disease.’
Dr Francesco Tamagnini, a dementia expert and neuroscientist from the University of Reading, said: ‘For Alzheimer’s, one of the holy grails, other than finding a cure and improve people’s quality of life, is to be able to screen people with something like a urine or blood test.
‘Just as we use a blood test to look for prostate cancer, or a mammogram to look for breast cancer, we need a simple, painless test to show early signs of dementia, even before the onset of memory loss, which can then be followed up later with scans or a spinal tap if needed.
‘However, we need more research before we find whether a urine test really will work in practice.’
Dr Sara Imarisio, head of strategic initiatives at Alzheimer’s Research UK, said: ‘This study explored how formic acid in urine could be used as an indicator of the disease and found that it could be as accurate as existing blood tests that are used in research settings.
‘While a combination of blood and urine diagnostic markers could one day provide tests that help improve the accuracy of Alzheimer’s diagnoses for people across the UK, we still need further research to understand how formic acid in urine is linked to the disease.
‘We need to see larger studies that follow more people over longer time periods.’
WHAT IS ALZHEIMER’S?
Alzheimer’s disease is a progressive, degenerative disease of the brain, in which build-up of abnormal proteins causes nerve cells to die.
This disrupts the transmitters that carry messages, and causes the brain to shrink.
More than 5 million people suffer from the disease in the US, where it is the 6th leading cause of death, and more than 1 million Britons have it.
As brain cells die, the functions they provide are lost.
That includes memory, orientation and the ability to think and reason.
The progress of the disease is slow and gradual.
On average, patients live five to seven years after diagnosis, but some may live for ten to 15 years.
- Loss of short-term memory
- Behavioral changes
- Mood swings
- Difficulties dealing with money or making a phone call
- Severe memory loss, forgetting close family members, familiar objects or places
- Becoming anxious and frustrated over inability to make sense of the world, leading to aggressive behavior
- Eventually lose ability to walk
- May have problems eating
- The majority will eventually need 24-hour care
Source: Alzheimer’s Association