New research unveils pathways to detect dementia earlier

Groundbreaking research has identified four distinct pathways to developing dementia, offering hope for earlier detection and improved treatment strategies.

Published in eBioMedicine, a journal under The Lancet Discovery Science, the study highlights how conditions such as depression, cognitive decline, heart disease, and brain dysfunction illnesses contribute significantly to dementia risk.

These findings could transform how clinicians approach diagnosis and care, potentially improving outcomes for Australians living with this devastating condition.

Four pathways to dementia

The study, conducted by American researchers at UCLA Health, analysed data from over 24,000 patients within the University of California Health system. It identified four key pathways linked to dementia development:

• Mental Health Pathway: This pathway, primarily affecting women and Hispanic individuals, centres on psychiatric conditions like depression. The research aligns with prior evidence suggesting a strong link between depression and an increased risk of Alzheimer’s disease.
• Cognitive Impairment Pathway: Characterised by mild cognitive impairment, particularly memory loss, this pathway highlights early cognitive decline as a critical indicator of dementia risk.
• Vascular Risk Pathway: Conditions such as hypertension, a common symptom of heart disease, were found to play a significant role in dementia development, underscoring the connection between cardiovascular health and brain function.
• Brain Dysfunction Pathway: This includes various neurological conditions that impair brain function, contributing to over a quarter of dementia cases in the study.

Each pathway has unique characteristics, often tied to specific demographics, which could enable doctors to tailor early detection strategies to at-risk groups.

Lead author Dr Timothy Chang, assistant professor of neurology at UCLA Health, emphasised that recognising these sequential patterns, rather than focusing on isolated diagnoses, could significantly enhance dementia diagnosis accuracy.

Why early detection matters

Dementia is a major health concern in Australia, currently the second leading cause of death overall and the leading cause for women.

According to Dementia Australia, an estimated 433,300 Australians are living with dementia in 2025, with projections suggesting this number could nearly double to 812,500 by 2054 without significant intervention. Notably, around 29,000 Australians have younger-onset dementia, affecting people as young as their 30s.

Early detection is crucial, as it allows for timely interventions that can slow disease progression and improve quality of life. The UCLA study suggests that understanding these pathways could lead to more precise risk assessments and targeted treatments, potentially reducing the burden of dementia on individuals and the healthcare system.

Additional insights from recent research

Beyond the UCLA study, other research has further illuminated innovative approaches to detecting dementia.

A 2024 study published in Nature Reviews Neurology explored the use of blood-based biomarkers, such as plasma p-tau217, which can detect Alzheimer’s-related changes in the brain years before symptoms appear.

These biomarkers offer a non-invasive, cost-effective method for screening, which could complement the pathway-based approach identified in the UCLA study. Additionally, advancements in neuroimaging, such as PET scans and MRI, have shown promise in identifying early brain changes associated with dementia.

A 2025 article in The Medical Journal of Australia highlighted how machine learning algorithms, when applied to imaging data, can predict dementia risk with up to 85% accuracy by analysing patterns of brain atrophy. Combining these technological advances with the UCLA findings could create a robust framework for early diagnosis.

Implications for Australia

The UCLA study’s findings are particularly relevant for Australia, where dementia poses a growing public health challenge. The research underscores the importance of integrating mental health, cardiovascular, and neurological assessments into routine medical care to identify at-risk individuals.

For instance, screening for depression or hypertension in middle-aged adults could serve as an early warning system for dementia risk.

First author Mingzhou Fu, a medical informatics pre-doctoral student at UCLA, noted that multi-step trajectories – where multiple conditions develop in sequence – indicate greater dementia risk than single conditions alone.

This insight could guide Australian healthcare providers in developing comprehensive screening programs that consider these interconnected risk factors.

Future directions

The UCLA researchers called for further studies to validate these pathways in diverse populations and explore the biological mechanisms behind them. In Australia, initiatives like the Australian Dementia Network (ADNeT) are already working to standardise diagnostic practices and improve access to clinical trials.

Integrating the UCLA findings into such frameworks could accelerate progress toward effective prevention and treatment strategies.

As dementia cases rise, the need for innovative detection methods has never been more urgent. By identifying these four pathways and leveraging emerging technologies like biomarkers and AI-driven imaging, researchers and clinicians are paving the way for earlier interventions, offering hope to millions of Australians affected by this condition.

For more information on dementia and support services, visit Dementia Australia at dementia.org.au.