A University of British Columbia researcher is exploring less invasive ways to find Alzheimer’s symptoms in the body by looking into the eye.
Robin Hsiung, an associate professor in UBC’s division of neurology, conducted a study that used the eye and brain from people who had donated their bodies to science. He wanted to see if the number of protein deposits on the retina could be related to the number of protein deposits in the brain.
“It’s much easier to visualize the eye than look into the brain,” said Hsiung.
“We hope some of it will work because, again, it would be much less invasive, and accessible.”
Alzheimer’s disease is a unique category of dementia that is caused by two major proteins in the brain. Tau and amyloid proteins create deposits that lead to brain-cell damage.
Hsiung looked primarily at the amyloid protein deposits in the study and he did find a relationship. People who had more deposits on the retina also had more deposits in the brain and more severe Alzheimer’s.
The study is a promising advance in Alzheimer’s research because it’s a less invasive alternative for testing than what is used now.
Finding less invasive testing options is one research goal. Currently, the traditional method is taking a cerebrospinal fluid sample from the lower spine. This procedure takes time and not everyone wants to have a needle in their back.
Hsiung’s research on the eye is still in the early stages. He’s now working with a physicist to develop an optic scan that would allow them to look at live patients. If successful, the scan could become a more convenient way to measure the protein changes.
Another aspect that researchers always have to consider in looking at Alzheimer’s is that the disease progresses over time. Hsiung addresses that in his research by collecting blood samples from his patients and storing them in a biobank at UBC.
The biobank started in 2008, giving Hsiung 10 years of information on how the disease progressed in many different people. It also provides an opportunity to test new predictive technologies on the blood samples as they’re developed.
Blood sampling is already used as a common diagnostic test for heart disease and diabetes. Finding ways to predict Alzheimer’s through blood as well would make diagnosing easier and more familiar for patients.
Experiencing progression: Life changes that come with a diagnosis
Receiving an Alzheimer’s diagnosis can be a harrowing process to go through. Ken Walker experienced this three and a half years ago when he was diagnosed at 58 years old.
Walker completed cognitive questionnaires, which showed that he had mild cognitive impairment. But getting a diagnosis was a struggle that lasted about a year.
“I knew a little bit about Alzheimer’s, in fact, a lot and one of the pieces of the story is we went to our doctor and I told him ‘I think there’s something wrong and from what I know I’m concerned that this might be Alzheimer’s’ and he just said ‘Oh well, you’re just of a certain age,’” said Walker.
“That was really harmful for me, to just dismiss me like that was just awful. What do I do, do I just walk out?”
The doctor gave Walker a referral to the Elder Care Clinic after the results of the questionnaire showed cause for concern. The appointment at the clinic was later cancelled because he was told he wasn’t old enough.
He did eventually get an appointment with the Elder Care Clinic when his doctor’s office contacted them. It was there that Walker was given another questionnaire and a confirmed diagnosis.
The questionnaires also don’t give a definitive diagnosis because they don’t look at the specific Alzheimer’s proteins. Instead, they narrow down the possibilities through a process of elimination.
Walker expressed interest in the possibility of an eye scan, but his husband Mark Demers was cautious.
“If that technology was easily and commonly available, like at the drugstore like they have the blood-pressure cuffs, then it would be really useful because then people could take it themselves,” said Demers.
“But the bottleneck for us was [getting a referral from] the doctor and that might not change with the different technology.”
Walker and Demers went through an adjustment process after the diagnosis and as Walker progressed to severe cognitive impairment. Two major changes Walker went through included no longer being allowed to ride his bicycle and losing the ability to read.
Support and maintained involvement in their community have played a big role in their lives to make the transition easier. Walker is now a part of the Alzheimer Society of BC’s leadership groups and volunteers his time whenever the opportunity arises.
“One of life’s essential needs is to feel like you’re contributing in some way and so even people with Alzheimer’s have the same needs and the same desires. He wanted to contribute, and so they put him on what I call the consumer board of the Alzheimer’s Society here,” said Demers.
“We have a student group at UBC as well through the health mentors program…all because he keeps saying ‘I want some more to do, I want to give back more’.”
The society provides resources for people who have been diagnosed along with their caregivers, family and friends. Their goal is to build a welcoming network in the community.
They offer a province-wide First Link Dementia Helpline for people who want to learn more about the disease or learn about the different resources available. The service is provided in English, Punjabi, Cantonese and Mandarin.