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Study Links 10 Conditions, Including Constipation, to Alzheimer’s Diagnosis

March 17, 2022

An inability to recall basic things like names, tasks and recent memories is a familiar sign of cognitive impairment such as Alzheimer’s disease, but other conditions also can provide early clues.

Researchers at the Paris Brain Institute compiled a list of 10 health conditions they were able to statistically link to a diagnosis of Alzheimer’s disease, sometimes a decade later.

“This is a fascinating list. I don’t think much is actually new, but putting it all together in one place is interesting,” said Dr. Amy Sanders, director of the Memory Care Center at Hartford HealthCare’s Ayer Neuroscience Institute.

The list includes:

• Major depression, which was the earliest condition the team linked to Alzheimer’s, appearing at least nine years before a diagnosis of the memory disorder.
• Anxiety.
• Constipation.
• Abnormal weight loss.
• Cervical spondylosis, a type of degenerative arthritis in the upper spine causing pain and muscle spasms.
• Reaction to severe stress.
• Hearing loss.
• Sleep disorders.
• Falls.
• Fatigue.

The research, published in The Lancet Digital Health journal, sparked the need for further investigation to determine whether these conditions are part of the cause of Alzheimer’s disease or early signs of changes in the brain happening as a result of its progression. Alzheimer’s disease, according to Dr. Sanders, can begin in the brain as many as 20 years before symptoms start to appear. Even so, she cautioned that the associations described in the research are not the same thing as casuality, so while the health conditions appear to be linked to Alzheimer’s disease, they have not yet been shown to cause it.

“The first time I heard about links between constipation and cognitive impairment was in the mid-1990s when the topic came up in a ‘tele-session’ on asthma that I was moderating. I never forgot it and, even today, I have an Epic ‘smart phrase’ on the subject,” Dr. Sanders said, referring to standard templates or blocks of text used by physicians and other medical professionals within the electronic medical record for topics that come up frequently.  “Indeed, I have Epic smart phrases about anxiety, hearing loss and sleep also. And I use them a lot.”

Other symptoms listed by the Paris Brain Institute team are less commonly associated with Alzheimer’s, she continued, admitting she has not seen several in her own practice.

“Weight loss is usually closer to the time of an Alzheimer’s diagnosis, or even as a herald for decline in the later stages of dementia. An association as much as a decade before diagnosis is new to me,” Dr. Sanders said. “Cervical spondylosis is entirely new to me and somewhat curious. I wonder what mechanism of the disease was considered. Was it pain? What, then, would make this condition special when so many conditions cause chronic pain?”