A new study suggests that a stool sample could be used to screen for Alzheimer's disease. Getty Images
A new study suggests that a stool sample could be used to screen for Alzheimer's disease. Getty Images
A new study suggests that a stool sample could be used to screen for Alzheimer's disease. Getty Images
A new study suggests that a stool sample could be used to screen for Alzheimer's disease. Getty Images

Your gut may know you're going to get Alzheimer's before you do


Marwa Hassan
  • English
  • Arabic

People in the earliest stage of Alzheimer's disease, prior to the onset of cognitive symptoms, have a different assortment of bacteria in their intestines than healthy individuals, a study has found.

The research opens up the possibility of using gut bacterial analysis to identify those at higher risk of developing dementia and to design treatments that alter the microbiome to prevent cognitive decline.

“We don’t yet know whether the gut is influencing the brain or the brain is influencing the gut, but this association is valuable to know in either case,” said co-corresponding author Gautam Dantas, Conan Professor of Laboratory and Genomic Medicine at Washington University in St Louis, Missouri.

Dr Dantas pointed out that there are two main possibilities.

One is that the changes in the gut microbiome are a reflection of pathological changes in the brain.

The alternative is that the gut microbiome contributes to Alzheimer's disease, and that changing it might alter the disease's course.

The idea of examining the gut microbiome's connection to Alzheimer's originated from a casual conversation between Dr Dantas and Beau M Ances, the Daniel J Brennan Professor of Neurology, during a children's football game.

Dr Ances, who studies and treats Alzheimer's patients, spoke with Dr Dantas, an expert on the gut microbiome, about the lack of research into the gut microbiomes of people in the pre-symptomatic phase of Alzheimer's.

“By the time people have cognitive symptoms, there are significant changes that are often irreversible,” Dr Ances explained.

The team has initiated a five-year follow-up study to determine whether these differences in gut microbiome are a cause or a result of the brain changes seen in early Alzheimer's. PA
The team has initiated a five-year follow-up study to determine whether these differences in gut microbiome are a cause or a result of the brain changes seen in early Alzheimer's. PA

However, if someone is diagnosed very early in the disease process, therapeutic intervention can be more effective.

During the study, the team evaluated participants who volunteered at the Charles F and Joanne Knight Alzheimer Disease Research Centre at Washington University.

To identify those in the early stage of Alzheimer's, they looked for signs of amyloid beta and tau accumulation using brain scans and cerebrospinal fluid.

They found that about a third of the 164 participants showed signs of early Alzheimer's.

Their analysis revealed significant differences in gut bacteria between healthy people and those with preclinical Alzheimer's, regardless of a largely similar diet.

The differences, which correlated with amyloid and tau levels, did not correlate with neurodegeneration, suggesting their potential use as early Alzheimer's screening tools.

According to Dr Ances, using the gut microbiome as a screening tool is advantageous due to its simplicity and accessibility.

Dr Ances envisions a future where people can provide a stool sample to assess their risk of developing Alzheimer's, an approach that would be less invasive and more accessible than brain scans or spinal taps.

The team has initiated a five-year follow-up study to determine whether these differences in gut microbiome are a cause or a result of the brain changes seen in early Alzheimer's.

Dr Dantas noted that if a causative link is found, it could likely be inflammatory.

“Bacteria are these amazing chemical factories, and some of their metabolites affect inflammation in the gut or even get into the bloodstream, where they can influence the immune system all over the body,” he said.

“All of this is speculative at this point, but if it turns out that there is a causal link, we can start thinking about whether promoting ‘good’ bacteria or getting rid of ‘bad’ bacteria could slow down or even stop the development of symptomatic Alzheimer’s disease.”

The research was carried out by researchers at the Washington University School of Medicine and was published in Science Translational Medicine.

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Favourite holiday destination: Malaysia. I went there for my honeymoon and ended up volunteering to teach local children for a few hours each day. It is such a special place and I plan to retire there one day.

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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

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“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

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The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”

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The worker must also have an attested educational certificate higher than secondary or an equivalent certification, and earn a monthly salary of at least Dh4,000. 

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Updated: June 15, 2023, 4:21 AM