"Scientists are finding more clues to help determine whether people with mild dementia symptoms are at risk for Alzheimers. A new study suggests that biomarkers found in cerebrospinal fluid fluid that surrounds the spinal cord and brain and acts as a protective cushion could predict who would develop Alzheimers disease  of the time among patients with mild cognitive impairment a condition characterized by measurable memory problems. Researchers report these findings in the journal Archives of General Psychiatry httparchpsyc.amaassn.orgcgicontentshort. This is the longest clinical followup ever of patients who begin with mild cognitive impairment researchers reported. Patients were tracked from four to  years with a median of . years.  The research builds on a  Lancet Neurology study http that followed patients for a median of . years beginning with a group of  volunteers with mild cognitive impairment.The new study is important because of the long followup period according to Adam Brickman assistant professor of neuropsychology at Columbia University School of Medicine who was not involved in the research. Knowing which patient with mild cognitive impairment patients may go on to develop Alzheimers is vital information for researchers who are looking for treatments for the fatal brain disease.  The current thinking is that interventions will be most effective when given to a patient as early as possible http Brickman said.  Clinical trials can better focus their efforts if patients are known to be in the early stages of Alzheimers.  Generally about  to  of patients with mild cognitive impairment show evidence of underlying symptoms of Alzheimers so not everyone with this condition is a good candidate for an Alzheimers trial. Researchers focused on two biomarkers previously thought to be involved in Alzheimers disease a kind of protein called betaamyloid and another protein type called tau.  Experts believe a decrease in betaamyloid in the fluid of the spinal cord is associated with a toxic buildup of that protein in the brain which causes the formation of plaques linked to Alzheimers disease.  Tau has been tied to neurofibrillary tangles  http_and_researchers_professionals_and_researchers_alzheimers_disease_pr.aspin the brain researchers find that an increase in tau in cerebrospinal fluid is associated with Alzheimers also. The results from the study suggest that betaamyloid is a much earlier predictor of Alzheimers disease than tau which supports the hypothesis that betaamyloid accumulation in the brain occurs first in the course of the disease. Some of the participants who were originally found to be stable with mild cognitive impairment after about five years went on to develop Alzheimers disease during the longer followup.  That suggests that a fiveyear followup period is not long enough to determine how well biomarkers can predict which patients will develop Alzheimers disease researchers say. The association between biomarkers in the fluid and Alzheimers was also described in studies in December  httparchneur.amaassn.orgcgicontentextract and August  httparchneur.amaassn.orgcgicontentabstract building on the idea that a spinal tap could be useful in predicting Alzheimers. When these sorts of studies get published Brickman and other doctors get phone calls from aging adults wondering whether they should be getting spinal taps to assess their risk.  But its too early to use this as a diagnostic tool in clinical settings says Brickman. Down the road the fantasy is that asymptomatic people will be able to get a biomarker test to determine whether theyll one day get Alzheimers but thats not possible right now he adds. What I tell people is If theyre worried about their thinking abilities that they should make an appointment with a neuropsychology or a neurologist to get an evaluation Brinkman says. The way we diagnose Alzheimers disease is by evaluating the behavior and the risk factor medical profile not by looking at biological markers at this point. As scientists gain more insight into predicting Alzheimers aging adults may struggle with the question of whether they want to know their risk http especially since theres still no cure.  Some people want to enroll in clinical trials http as soon as they start showing symptoms others would rather be ignorant of their status since there is no cure.  In looking for treatments however researchers depend on peoples willingness to contribute to science. The Alzheimers Association runs a system called TrialMatch http_trialsfind_clinical_trials_trialmatch.aspgclidCKTlLelsqCFQLrKgodTlTolg. Check it out if youre interested in finding a trial for yourself or someone you care about."