What can the retinal vasculature tell us about the pathogenesis of Alzheimer’s disease?

Summary

Alzheimer's disease (AD) is the most common dementia, accounting for two-thirds of cases worldwide. It is a progressive disease, leading to memory loss, disability and death. Current treatments for AD can slow its progress but do not cure the disease.

In AD, abnormal proteins accumulate in the brain, damaging brain cells and eventually causing them to die. These harmful changes can occur up to 20 years before memory problems and other clinical symptoms become noticeable. To date, most AD research has focused on how these abnormal proteins affect brain function. We have exciting new evidence from our research that changes to the brain's blood supply could be one of the earliest steps in the development of AD, before brain cells start to die.

Brain scans aren't sensitive enough to pick up changes to small blood vessels in the brain. Instead, we can look at and analyse the small vessels at the back of the eye, which share the same blood supply as the brain. Therefore, by examining the eye, we can find out how changes to the blood supply of the brain lead to the development of AD.

In this proposal, we plan to look for novel genetic, environmental and disease risk factors associated with changes to the small blood vessels of eye among participants in a large population study, UK Biobank. Next, we will work out which of these risk factors could explain the changes to the blood supply of the eye and brain that lead to AD.