Pupillary dilation responses as a midlife indicator of risk for Alzheimer’s Disease: Association with AD

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cdamaden
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Pupillary dilation responses as a midlife indicator of risk for Alzheimer’s Disease: Association with AD

Postby cdamaden » Wed Sep 18, 2019 9:10 am

Results held up after controlling for APOE genotype. Results support pupillary response—and by inference, LC dysfunction—as a genetically-mediated biomarker of early MCI/AD risk. In combination with other biomarkers, task-evoked pupillary responses may provide additional information for early screening of genetically at-risk individuals even before cognitive declines.
https://www.sciencedirect.com/science/a ... via%3Dihub
Chris
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Re: Pupillary dilation responses as a midlife indicator of risk for Alzheimer’s Disease: Association with AD

Postby NF52 » Fri Sep 20, 2019 6:44 am

cdamaden wrote:Results held up after controlling for APOE genotype. Results support pupillary response—and by inference, LC dysfunction—as a genetically-mediated biomarker of early MCI/AD risk. In combination with other biomarkers, task-evoked pupillary responses may provide additional information for early screening of genetically at-risk individuals even before cognitive declines.
https://www.sciencedirect.com/science/a ... via%3Dihub
Thanks for sharing this, Chris.

Lots of interest in the area of using ocular changes to predict Alzheimer's "risk". As noted here, it seems right now to be for "early screening" in order to "enrich" clinical trials with people most likely to show benefit from a potentially effective treatment or decrease in function if in the placebo group.

My concern with these studies is more practical: I think they are far from ready for "prime time" use in telling someone that they WILL move to MCI/AD. None of these studies, as far as I know, have followed people long enough to say that those who are in the upper quartile and not the lower quartile of risk actually do convert to MCI or AD. So as with any predictive test (PSA, mammograms, etc.) the question would be how may people would get a false positive: A prediction from their doctor that they are moving towards MCI, when in facts there may be only 40-50% predictive factor over the next 10 years. Frankly, even if they are 100% predictive, I'm not sure I would want to hear this news 5-10 years before I am likely to experience subjective cognitive decline or the beginnings of MCI.
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