Two new studies from the Indiana University School of Medicine are offering a clearer picture of Alzheimer’s disease — both how it changes the brain and what early screening means for caregivers.
Together, the research shows progress in understanding the disease, while also highlighting gaps in support for families.
In the first study, researchers looked at how different parts of the brain use energy and communicate as Alzheimer’s develops. The team analyzed brain scans and blood tests from hundreds of people, including those with no cognitive issues, mild cognitive impairment and Alzheimer’s disease.
Led by Paul R. Territo and Juan Antonio Chong Chie, the study examined the brain as a connected system — similar to a city’s power grid — instead of focusing on isolated regions.
Researchers found that Alzheimer’s does not progress in a straight line.
“Instead, network density and connectivity followed a striking ‘W’ shaped pattern across disease stages, suggesting the brain undergoes phases of breakdown and compensation as it struggles to maintain its normal function,” Chong Chie said.
In early and middle stages, areas of the brain responsible for memory and language use more energy, suggesting the brain is working harder to compensate for damage. As the disease progresses, those same areas begin to decline, while regions tied to movement remain active longer.
This may help explain why memory loss often appears before physical symptoms.
The study also found differences between men and women. In men, brain networks shrink and lose connection over time. In women, networks become more fragmented.
“These findings point to different disease patterns in male and female brains, which may help explain why women are disproportionately affected by Alzheimer’s disease,” Territo said.
Researchers also measured how efficiently the brain sends information. They found that efficiency improves for a short time during early decline, then worsens as Alzheimer’s advances.
“These changes in path length and network organization were most noticeable during the transition states from early to late mild cognitive impairment, a stage that could be crucial for therapeutic intervention,” Territo said.
Researchers say this stage could be an important window for treatment, though more research is needed before these findings are used in clinical care.
A second study focused on caregivers and family members.
Led by Nicole R. Fowler, the study followed 1,808 patients age 65 and older and their family members across 29 Indiana clinics. JAMA Internal Medicine published the findings.
Researchers examined whether Alzheimer’s screening in primary care affected caregivers’ mental health and preparedness.
They found that screening did not increase anxiety, depression or reduce quality of life for family members over two years.
“The study provides reassuring evidence that screening did not worsen family members’ quality of life, depression or anxiety over two years,” Fowler said.
However, screening also did not make caregivers feel more prepared.
INDIANAPOLIS — A new study conducted by Indiana University School of Medicine researchers has found that primary care screenings for Alzheimer’s disease and related dementias (ADRD) in older adults did not cause psychological distress for the patient’s family members, nor did it better prepare those loved ones for caregiving.
The randomized clinical trial, published in JAMA Internal Medicine, is the first study to examine the longer-term benefits, risks and harms of ADRD screening in primary care for family members most likely to assume caregiving responsibilities. It examined 1,808 patient-family member pairs across 29 Indiana clinics. Each patient was at least 65 years old.
“Delayed diagnosis is associated with greater caregiver stress, burden and isolation, and early detection may help families through education, earlier intervention and support,” Fowler said. “But this study makes an important distinction: screening alone is not the same as early diagnosis and getting people and their families linked to care.”
Fowler said what happens after screening — including diagnosis, treatment and ongoing support — is what truly affects families.
“The message from this work is that early diagnosis may help caregivers when it actually leads to diagnostic assessment, treatment and ongoing support, not simply when a screening test is offered,” Fowler said.
Together, the studies show that while researchers are improving how to understand and track Alzheimer’s, patients and caregivers need better systems to connect to care after screening.
This reporting is made possible by a grant from the Indianapolis African-American Quality of Life Initiative, empowering our community with essential health insights. https://iaaqli.org/
Contact Health & Environmental Reporter Hanna Rauworth at 317-762-7854 or follow her on Instagram at @hanna.rauworth.
Hanna Rauworth is the Health & Environmental Reporter for the Indianapolis Recorder Newspaper, where she covers topics at the intersection of public health, environmental issues, and community impact. With a commitment to storytelling that informs and empowers, she strives to highlight the challenges and solutions shaping the well-being of Indianapolis residents.
