Early diagnosis of Alzheimer’s disease could be a step closer should regulatory approval be given to an eye test assisted by artificial intelligence.
Although new drugs are making the condition easier to treat, diagnosis remains a challenge for doctors.
That could be about to change.
Technology developed by Canadian medical imaging firm RetiSpec claims to offer a window to the brain to detect early signs of the degenerative disease.
This kind of brain imaging can help us to arrive at a diagnosis
Dr Prachet Kulkarni Krishnamurthy
AI technology mounted on an optometrist's camera evaluates a retinal scan of the back of a patient’s eye.
Images can reveal the presence of amyloid, a sticky protein that begins to develop in the early stages of Alzheimer’s disease.
On detecting the protein, a sensor relays information into an AI algorithm to determine the pathology of the disease.
Earlier treatment, better results
Eye tests are already known to help medical professionals diagnose several conditions, by giving a view of tiny blood vessels that supply the retina.
Images can help doctors diagnose diabetes, high blood pressure, thyroid disease, rheumatoid arthritis and brain tumours.
Although still in the midst of approval processes in North America, scientists said the new test could enable earlier treatment for those most vulnerable to Alzheimer’s.
“Alzheimer's is very common with a high disease burden in the elderly – both for the patient and the family, so it is important to identify it early,” said Dr Prachet Kulkarni Krishnamurthy, consultant neurologist at NMC Royal Hospital Sharjah.
“This kind of brain imaging can help us to arrive at a diagnosis in conjunction with clinical findings and after excluding other causes.
“It can also help us to exclude other causes which can mimic Alzheimer's disease, educate the care giver and start the new promising drugs early.”
Alzheimer's disease is one of the most common degenerative diseases in older people.
Experimental drug Donanemab has shown to slow the progression of the disease by up to 35 per cent during clinical trials.
The drug works by removing amyloid from the brain.
The disease is characterised by progressive loss of memory, intellectual capacity, ability to judge, calculate, an inability to frame sentences and speak.
“The signs of Alzheimer's disease are memory loss disrupting daily life,” said Dr Krishnamurthy.
“It can cause difficulty in planning or solving problems, difficulty in completing familiar tasks or an inability to understand visual images or spatial relationships.
“There can also be problems with speaking and writing, misplacing things, poor judgment, withdrawal from work or social activities and changes in mood and personality.
“It is important to know there are many diseases which can mimic Alzheimer's disease, for example nutritional deficiency and thyroid abnormalities, which can and should be treated early so accurate diagnosis methods are important.”
Symptoms of Alzheimer’s can occur in varied combinations and at different times.
The incidence is directly proportional to age, meaning the older the individual, the higher the chance of getting Alzheimer's.
Around five per cent of people above 65, 13 per cent those above 75, and 33 per cent of people over 85 have the disease.
Less invasive testing
Typically, doctors would detect early signs of Alzheimer’s using diagnostics such as a positron emission tomography (or PET) scan.
The test produces images of organs and tissues by injecting a radioactive chemical called a radiotracer.
The scanner detects diseased cells that absorb large amounts of the radiotracer, which indicates a potential health problem.
Like a spinal tap, which is also used, diagnostic tools can be expensive, and invasive.
Using a simple eye test could transform the way medics look for the disease.
Dr Sharon Cohen, a neurologist and medical director at Toronto Memory Programme, worked as a scientific consultant with RetiSpec.
“The RetiSpec team is moving Alzheimer’s disease biomarker science forward in an exciting direction,” she said.
“Retinal imaging holds promise for clinicians, patients, and those involved in drug development to pre-screen and predict cerebral amyloidosis in a non-invasive manner within the clinic setting.”
Meanwhile, Dr Wissam Charafeddin, an ophthalmology consultant at Barraquer Eye Hospital UAE Dubai, said more research was required.
"It is important to keep in mind that while retinal Hyperspectral Imaging (rHSI) cameras are highly promising, challenges such as standardisation, data interpretation, and accessibility remain.,” he said.
“Developing robust algorithms to analyse hyper-spectral data and distinguish between normal ageing changes and Alzheimer's-related alterations is a complex task and requires large, controlled studies.”
SHAITTAN
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Islamophobia definition
A widely accepted definition was made by the All Party Parliamentary Group on British Muslims in 2019: “Islamophobia is rooted in racism and is a type of racism that targets expressions of Muslimness or perceived Muslimness.” It further defines it as “inciting hatred or violence against Muslims”.
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
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The President's Cake
Director: Hasan Hadi
Starring: Baneen Ahmad Nayyef, Waheed Thabet Khreibat, Sajad Mohamad Qasem
Rating: 4/5
Tributes from the UAE's personal finance community
• Sebastien Aguilar, who heads SimplyFI.org, a non-profit community where people learn to invest Bogleheads’ style
“It is thanks to Jack Bogle’s work that this community exists and thanks to his work that many investors now get the full benefits of long term, buy and hold stock market investing.
Compared to the industry, investing using the common sense approach of a Boglehead saves a lot in costs and guarantees higher returns than the average actively managed fund over the long term.
From a personal perspective, learning how to invest using Bogle’s approach was a turning point in my life. I quickly realised there was no point chasing returns and paying expensive advisers or platforms. Once money is taken care off, you can work on what truly matters, such as family, relationships or other projects. I owe Jack Bogle for that.”
• Sam Instone, director of financial advisory firm AES International
"Thought to have saved investors over a trillion dollars, Jack Bogle’s ideas truly changed the way the world invests. Shaped by his own personal experiences, his philosophy and basic rules for investors challenged the status quo of a self-interested global industry and eventually prevailed. Loathed by many big companies and commission-driven salespeople, he has transformed the way well-informed investors and professional advisers make decisions."
• Demos Kyprianou, a board member of SimplyFI.org
"Jack Bogle for me was a rebel, a revolutionary who changed the industry and gave the little guy like me, a chance. He was also a mentor who inspired me to take the leap and take control of my own finances."
• Steve Cronin, founder of DeadSimpleSaving.com
"Obsessed with reducing fees, Jack Bogle structured Vanguard to be owned by its clients – that way the priority would be fee minimisation for clients rather than profit maximisation for the company.
His real gift to us has been the ability to invest in the stock market (buy and hold for the long term) rather than be forced to speculate (try to make profits in the shorter term) or even worse have others speculate on our behalf.
Bogle has given countless investors the ability to get on with their life while growing their wealth in the background as fast as possible. The Financial Independence movement would barely exist without this."
• Zach Holz, who blogs about financial independence at The Happiest Teacher
"Jack Bogle was one of the greatest forces for wealth democratisation the world has ever seen. He allowed people a way to be free from the parasitical "financial advisers" whose only real concern are the fat fees they get from selling you over-complicated "products" that have caused millions of people all around the world real harm.”
• Tuan Phan, a board member of SimplyFI.org
"In an industry that’s synonymous with greed, Jack Bogle was a lone wolf, swimming against the tide. When others were incentivised to enrich themselves, he stood by the ‘fiduciary’ standard – something that is badly needed in the financial industry of the UAE."
THE%20SPECS
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Brief scoreline:
Liverpool 2
Mane 51', Salah 53'
Chelsea 0
Man of the Match: Mohamed Salah (Liverpool)
Aston martin DBX specs
Engine: 4.0-litre twin-turbo V8
Transmission: nine-speed automatic
Power: 542bhp
Torque: 700Nm
Top speed: 291kph
Price: Dh848,000
On sale: Q2, 2020
Jigra
Starring: Alia Bhatt, Vedang Raina, Manoj Pahwa, Harsh Singh
Six large-scale objects on show
- Concrete wall and windows from the now demolished Robin Hood Gardens housing estate in Poplar
- The 17th Century Agra Colonnade, from the bathhouse of the fort of Agra in India
- A stagecloth for The Ballet Russes that is 10m high – the largest Picasso in the world
- Frank Lloyd Wright’s 1930s Kaufmann Office
- A full-scale Frankfurt Kitchen designed by Margarete Schütte-Lihotzky, which transformed kitchen design in the 20th century
- Torrijos Palace dome
Poland Statement
All people fleeing from Ukraine before the armed conflict are allowed to enter Poland. Our country shelters every person whose life is in danger - regardless of their nationality.
The dominant group of refugees in Poland are citizens of Ukraine, but among the people checked by the Border Guard are also citizens of the USA, Nigeria, India, Georgia and other countries.
All persons admitted to Poland are verified by the Border Guard. In relation to those who are in doubt, e.g. do not have documents, Border Guard officers apply appropriate checking procedures.
No person who has received refuge in Poland will be sent back to a country torn by war.
Profile of Foodics
Founders: Ahmad AlZaini and Mosab AlOthmani
Based: Riyadh
Sector: Software
Employees: 150
Amount raised: $8m through seed and Series A - Series B raise ongoing
Funders: Raed Advanced Investment Co, Al-Riyadh Al Walid Investment Co, 500 Falcons, SWM Investment, AlShoaibah SPV, Faith Capital, Technology Investments Co, Savour Holding, Future Resources, Derayah Custody Co.
