According to the National Institutes of Health (NIH), more than 7 million Americans are currently estimated to be living with Alzheimer’s disease. Many others live with related dementia. When we think about this debilitating disease, the first symptom that usually comes to mind is memory loss. A new study, however, suggests that may not be the first indication of developing Alzheimer’s.
“In 1906, German physician Dr. Alois Alzheimer first described ‘a peculiar disease’ — one of profound memory loss and microscopic brain changes — a disease we now know as Alzheimer's,” the Alzheimer’s Association wrote. We know much more about it today. Yet it remains the fifth leading cause of death among Americans 65 and older. Deaths attributed to Alzheimer’s increased 134% between 2000 and 2024.
The Alzheimer’s Study
Diagnosing the illness can be tricky, and memory loss is usually the first sign associated with Alzheimer’s. A new study published in June in Nature Communications, however, found another early warning sign. Cognitive flexibility, or the ability to adjust when circumstances change, appeared months before memory problems in their experiments. Someone might still remember how to perform a familiar task perfectly well but have increasing difficulty changing the way they do it when circumstances change.
For example, if the usual route on the way to the grocery store is blocked by a road closure, someone with early Alzheimer's might have difficulty trying to figure out what to do. The person hasn’t necessarily forgotten the original task of driving to the store; the difficulty happens when they have to recognize that the old and familiar approach doesn’t work and something new must be done.
Researchers used mice that were genetically engineered to rapidly develop amyloid-beta buildup and other brain changes, essentially giving them Alzheimer’s. The subjects were taught that pressing one lever produced one type of food pellet and pressing another lever produced a different one. Then they switched the rules so that the levers produced the opposite rewards.
They found that healthy mice adjusted their behavior, but the Alzheimer’s subjects had more difficulty learning the new rules. The unhealthy mice were only three months old at this point of the experiment, which is considered an early stage of disease development. They also tested the animals’ spatial learning by using mazes and found that both sets of mice performed about the same. At six months, though, the Alzheimer’s mice started showing difficulties here as well.
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People tend to think that the brain slows down for people with dementia or Alzheimer’s, but the study showed that a part of the brain actually speeds up and causes issues. Scientists studied a brain pathway in the Alzheimer's mice, areas that help us make decisions, pursue goals, and change our behavior when circumstances change. They found that this area became too active, not less active. The neurons in the prefrontal cortex were firing more than normal and receiving stronger excitatory signals.
Researchers wanted to know what would happen if they were able to slow down this part of the brain. They discovered doing so reduced amyloid accumulation, brought some of the abnormal brain signaling closer to normal, increased acetylcholine levels, and improved the mice’s ability to learn when rules changed.
What Could This Mean for Humans?
The study suggested two findings that may help detect and treat Alzheimer’s disease in humans. First, memory loss may not be the first symptom, and instead signs of changes in executive functions, such as adapting to changing circumstances, may be noticed before other indicators. Second, slowing certain areas of the brain during the early stages of the disease may help preserve cognitive function or slow the disease’s progression.
It is important to note that this study was conducted with mice and doesn’t establish that humans who show signs of difficulty adapting to change have Alzheimer’s disease. But it is one more step on the road to understanding and treating this horrible disease that affects millions every year.









