Alzheimer’s Early Detection Tests Using Video Games Could Be As Effective as Blood Tests and Boost Clinical Trials

Alzheimer’s early detection tests using video games developed by Rutgers-Newark researchers may help spot the disease years before symptoms are noticeable and provide a non-invasive form of dementia screening. 

The innovative Rutgers dementia tests match the results of a new generation of blood tests that reveal biomarkers for Alzheimer's disease and are widely available. However, this non-invasive form of  screening is painless and doesn’t require blood samples, bypassing the need for trained technicians. The tests could also be more cost effective for doctors, according to Rutgers-Newark researchers. 

Video Games Were Created by Rutgers-Newark Researchers. See video here.

The study comes from the Aging & Brain Health Alliance at Rutgers-Newark, which  focuses on the role of lifestyle and genetics in delaying Alzheimer's. Their latest discovery could be a boon to pharmaceutical researchers since it points to a non-invasive way to choose drug trial participants who are in the earliest stages of the disease, said neuroscientist Mark Gluck, the lab’s director.

That could shave years off a clinical trial timetable. Researchers would no longer have to wait for the disease to be conventionally diagnosed. Doctors now believe changes in the brain start 10 to 15 years before they produce obvious impairment.

“It's pretty exciting for us because even before any problems with cognition become obvious, we have an early warning sign,” said lead author Miray Budak of the Center for Molecular & Behavioral Neuroscience. The study appears in the journal Alzheimer's Research & Therapy. 

Over the past 20 years, the Aging & Brain Health Alliance developed and tested the computerized video-game screening  to detect reduced brain function years before patients or their loved ones notice symptoms; now they have more evidence confirming that it is effective.

Gluck envisions a day when these tests can be administered at a doctor's office on a laptop or even remotely over the internet for patients who no longer drive or lack easy access to medical care.

The video-game test, called a generalization task, measures cognitive ability by showing how well a person can deduce a rule related to colors and shapes, then apply that rule to new examples. A different assessment, also developed by Gluck's team at Rutgers, uses MRI imaging to spot declines in brain flexibility, or the ability of neurons in and around the brain’s hippocampus region to communicate with each other. The hippocampus is one of the brain regions affected in the very earliest stages of Alzheimer's.

In the recent study, the 148 participants took a battery of cognition tests including the Rutgers generalization task, then gave blood samples and underwent a brain MRI. In order to be included, they had to be cognitively unimpaired; anyone who was already diagnosed with Alzheimer's disease was excluded from the study.  

Gluck directs the Rutgers Pathways to Healthy Aging in African Americans program, which focuses on Alzheimer's disease in the African-American community. All participants in this study were African Americans, who are more than twice as likely to develop Alzheimer's as other racial groups, and yet are underrepresented in national research on aging and Alzheimer's disease. However, the results of this new study would most likely apply to all races, said Budak.

The current standard battery of cognition tests, often used by neuropsychologists and neurologists, involve drawing a clock face, for example, or recalling a list of words – pick up Alzheimer's disease symptoms too late in the game, Gluck said.

“These off-the-shelf standard tasks have been around for decades but they are are not sensitive to the very earlierst changes that happen in Alzhiemer's disease, years before the more easily measured dementia and memory problems arise," he said.

The standard tests for cognitive decline currently in use have other drawbacks as well: they assume some level of education and cultural knowledge, making them less accurate for patients from all backgrounds and those without much education. The Rutgers tests, by contrast, require only rudimentary knowledge of shapes and colors.  And because they don't rely on language skills, they can also be used worldwide.

Modern medicine has found no way to repair or reverse the damage from Alzheimer's disease. Most drug research is aimed at slowing or postponing a patient's decline. But early intervention can make a difference.

Bernadette A, Fausto, one of the study’s co-authors, said she sometimes encounters people who have a misunderstanding about the disease's timetable. “They think, it isn't going to happen to me. I'm over 60 and it hasn't happened yet,” she said. If informed about their test results, “They could become more protective of their brain health.”