New research from Duke Health shows early detection of Alzheimer’s disease is possible through a quick nasal swab – often before cognitive problems occur.
Researchers used a small brush to collect living cells in the lining of the nose, close to the brain. After analysis, the cells revealed patterns and changes linked to the memory loss disease.
Vince D’Anniballe is the lead author of the study. He said loss of smell is a common symptom of Alzheimer's.
“Because of that association, we asked, ‘Could we detect Alzheimer's in the nose, and how early could we detect it?’” he said.
Most Alzheimer's research comes from autopsy tissue – studying the brain after a patient passes away. D’Anniballe said the new method allows researchers to look at the disease in real time.
“But, now really, for the first time, we can study living neural tissue,” he said. “And that opens new possibilities for diagnosis and treatment of Alzheimer's.”
D’Anniballe said the procedure is quick – more precise than a COVID-19 swab. After applying a numbing spray, a clinician guides a small brush into the top of the nose using a camera. The target is the olfactory cleft – the region where odor-detecting neurons live.
“Just a few seconds, really, we can capture the cells we need,” he said.
The appeal of the nasal swab method – D’Anniballe said – is that it’s less invasive than other detection methods.
One common method involves collecting Cerebral Spinal Fluid (CSF) by inserting a needle into the lower part of the back between vertebrates.
“Anecdotally, we've had people say that they'd much prefer the nasal swabbing over the CSF collection,” D’Anniballe said. “CSF collection is invasive. It can be uncomfortable.”
While blood testing is another option, those tests typically only show markers that appear later in the progression of the disease, according to Duke Health.
Alzheimer’s is a progressive disease. According to the Alzheimer’s Association, it damages brain cells – causing cognitive decline, memory loss and behavioral changes. Though no cure exists, treatments manage symptoms and slow the progression.
Mary Umstead is a participant in the study. In a video provided by Duke Health, she said she jumped at the opportunity to participate in the research in honor of her late sister, Mariah – who was diagnosed with young-onset Alzheimer’s at 57.
She said they saw the signs long before Maria’s diagnosis.
“I would never want any family to have to go through that kind of loss that we went through with Mariah.” she said, “And I would never want any patient to go through what she went through either.”
Umstead said she wanted to help, and being part of the research was the answer.
“We all think we can’t do anything,” she said. “But we can all be part of an element. And our small part and everybody else’s small part makes progress happen.”
D’Anniballe said treatments are most effective in the early stages of the disease – when it’s usually hardest to catch.
“The idea is that the sooner we get ahead of it, the earlier we can initiate treatment,” he said. “And then, we can envision a world where we can completely prevent Alzheimer's from progressing.”
D’Anniballe’s study included 22 participants. He said a larger group study is necessary before this becomes a standard detection method.
The Duke team will collaborate with the Duke & UNC Alzheimer’s Disease Research Center to expand the research and explore if treatment can be monitored through a nasal swab over time.
