Scientists have listed health conditions that could signal Alzheimer's disease years earlier

"We can halve the incidence rate of dying Alzheimer's disease within five years," said Professor Xue Zhong.

Scientists have identified four broad categories of medical conditions that could help doctors identify those at risk for Alzheimer's disease decades before symptoms develop — which could help halve its incidence.

Alzheimer's disease begins within decades, and certain medical conditions during midlife such as high blood pressure, hyperlipidemia, and stroke are associated with increased risk later in life.

However, more medical conditions can predict the development of this neurodegenerative disorder: a study by Vanderbilt Health researchers identified 70 of these individual disorders.

"If we identify several clinical conditions that predict the development of Alzheimer's disease 10 years or more later, we can intervene before symptoms of memory and/or cognitive impairment become apparent," said paper author Xue Zhong in a statement.

“It is predicted that delaying the onset of Alzheimer's disease by just five years could reduce its incidence by half.”

To systematically identify comorbid conditions associated with the development of Alzheimer's disease, researchers analyzed de-identified electronic health records (EHRs) from two independent databases.

They used MarketScan, a US database of more than 150 million people, as a discovery cohort and Vanderbilt Health's EHR system, which includes about 3 million patients, as an independent cohort to validate Discovery Tracker's findings.

Researchers identified 43,508 people diagnosed with Alzheimer's disease in the MarketScan database and 419,455 controls matched for age and sex, and 1,320 cases and 12,720 matched controls in the Vanderbilt Health system.

By tracking EHRs over a period of 10 years prior to Alzheimer's diagnosis and comparing EHRs between cases and controls, the researchers identified more than 70 conditions that appeared in both databases.

These include mental health conditions (eg, depression and severe neuropsychiatric symptoms such as paranoia/psychosis and suicidal ideation);Neurological and sleep-related conditions such as insomnia, hypersomnia, and sleep apnea;Cardiovascular/circulatory conditions such as essential hypertension, cerebral atherosclerosis, and cerebral ischemia;And endocrine / metabolic conditions, for example, type 2 diabetes.

The authors state that EHR associations do not prove a causal role for conditions, but they offer a data-driven roadmap for early risk identification and prevention-oriented research.

"Longitudinal EHRs provide powerful insight into the multi-year development of Alzheimer's disease," Zhong said."By identifying treatment patterns that often precede Alzheimer's disease, we can open new opportunities for risk reduction, early intervention, and improved patient outcomes."

According to Zhong, studies have shown that hypertension and hypercholesterolemia are risk factors for the development of Alzheimer's disease late in life, suggesting that addressing these conditions in midlife, either through healthy lifestyles or medication, may reduce the risk of Alzheimer's disease.

Across the study, the researchers also found a distinct association between cancer and Alzheimer's disease across the two EHR datasets, replicating previous disease findings.

“We are currently studying the mechanisms underlying this phenomenon, with the goal of generating insights that could inform new treatment strategies for Alzheimer's disease,” said Zhong.

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Zhong, X., Jia, G., Yin, Z., Chen, R., Cheng, K., Rzhetsky, A., Li, B., & Cox, N. J. (2025). https://doi.org/10.1186/s13195-025-01914-4