UCLA researchers say its more than just risk factors
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UCLA Health researchers mapped four distinct pathways leading to Alzheimers disease using electronic health records.
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The findings suggest that tracking diagnostic sequences predicts Alzheimers risk better than analyzing isolated conditions.
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The study, validated with a nationally representative cohort, could transform early detection, personalized prevention, and intervention strategies.
Who is most at risk of developing Alzheimers disease? If doctors knew the definitive answer, it might lead to earlier treatment and diagnosis. Researchers at UCLA may have uncovered some helpful clues.
Writing in the journal eBioMedicine, the researchers at UCLA Health said they have identified four unique diagnostic pathways that can lead to Alzheimer's disease, offering a more nuanced understanding of how the neurodegenerative condition develops over time.
By analyzing electronic health records from nearly 25,000 patients, the study sheds light on how specific sequences of medical conditions not just individual risk factors can influence a persons likelihood of developing Alzheimers. The research marks a significant departure from traditional approaches that focus on isolated risk conditions.
Instead, UCLA scientists mapped the step-by-step clinical trajectories that precede an Alzheimers diagnosis, offering new tools for early detection and prevention.
Patterns, not just risk factors
We found that multi-step trajectories can indicate greater risk factors for Alzheimers disease than single conditions, said first author Mingzhou Fu, a medical informatics pre-doctoral student at UCLA. Understanding these pathways could fundamentally change how we approach early detection and prevention.
The study identified four primary diagnostic trajectories:
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Mental Health Pathway Psychiatric conditions such as depression or anxiety that eventually lead to cognitive decline
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Encephalopathy Pathway Disorders involving brain dysfunction that worsen progressively
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Mild Cognitive Impairment Pathway A gradual decline in memory and cognitive functions, often preceding Alzheimer's
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Vascular Disease Pathway Cardiovascular conditions like hypertension that heighten the risk of dementia
Each pathway was linked with distinct demographic and clinical features, suggesting that different subgroups of the population may be predisposed to different disease routes.
Chronology of conditions
The researchers found that 26% of all diagnostic sequences showed a consistent, directional order. For instance, patients with hypertension frequently developed depressive episodes before being diagnosed with Alzheimers. These patterns, according to the team, may be key to identifying at-risk patients earlier in their disease progression.
Recognizing these sequential patterns rather than focusing on diagnoses in isolation may help clinicians improve Alzheimers disease diagnosis, said Dr. Timothy Chang, the studys senior author and assistant professor of Neurology at UCLA Health.
The team validated their findings using the All of Us Research Program, a diverse and nationally representative database. The confirmation of these patterns across a wide population enhances the studys relevance and applicability to clinical practice nationwide.
The study concluded that the innovative use of longitudinal electronic health data signals a promising shift in Alzheimers research, moving toward predictive and personalized care models that could significantly improve patient outcomes.
Posted: 2025-07-08 10:58:17
