Una risonanza magnetica e un algoritmo possono stimare l’età biologica e prevedere il rischio di demenza, aprendo la strada a screening personalizzati Quanti anni mi dai? La domanda può assumere valenze diverse, in base a quanto la persona si sente bene e in forma.
Perché l’età biologica può non corrispondere esattamente a quella anagrafica, anche e soprattutto se si parla delle attività del sistema nervoso e sulle capacità cognitive del soggetto. Comprendere prima possibile la discrepanza tra il benessere neurofisiologico atteso e la traiettoria di salute che ci si può aspettare in base alla carta d’identità diventa una sfida fondamentale per la salute del singolo e per la sostenibilità del sistema sanitario, con una bolla demografica destinata a metterlo a dura prova.
Ci vorrebbe uno strumento su misura, viene da pensare, per puntare su uno screening che in età adulta sia in grado di disegnare il percorso futuro di benessere neurologico. E non solo. Una proposta in questo senso viene da una ricerca che ha visto protagonisti gli esperti dell’Università Duke, di Harvard e della Otago University in Nuova Zelanda, apparsa su Nature Aging. Lo studio, in pratica, propone uno strumento in grado di determinare la velocità con cui una persona sta invecchiando e soprattutto preconizzare quale sarà il periodo di benessere neurofisiologico, grazie ad una singola risonanza magnetica.
Individuare chi è a rischio
«La cosa davvero interessante è che abbiamo registrato la velocità con cui le persone invecchiano utilizzando i dati raccolti durante la mezza età. E questo ci sta aiutando a prevedere la diagnosi di demenza tra le persone molto più anziane». In queste parole di Ahmad Hariri, docente di Psicologia e Neuroscienze all’Università Duke, sta il patrimonio potenziale di uno studio che si propone di giocare d’anticipo (ovviamente in termini di rischio) su potenziali diagnosi di neurodegenerazione in età avanzata. Il tutto, nella speranza di offrire oppornità future per un approccio mirato a chi presenta profili di pericolo maggiori già prima della comparsa dei segni e dei sintomi dei processi patologici.
Siamo quindi all’inizio di un percorso, ma le speranze di disporre di algoritmi mirati a offrire possibili “orologi dell’invecchiamento” cresce. Anche perché la ricerca e l’algoritmo messo a punto potrebbero consentire di individuare una misura della velocità con cui si sta sviluppando il processo, senza considerare possibili agenti esterni in grado di influenzarlo. Soprattutto, l’indagine tiene in considerazione gli stessi soggetti fin dalla nascita, proponendoli come “campioni” di valutazione del loro stesso benessere.
Lo studio Dunedin e la Rm
I ricercatori hanno infatti utilizzato i dati raccolti da circa 1.037 persone studiate nell’ambito dello Studio Dunedin, così chiamato dalla città neozelandese che ha visto venire al mondo le persone sotto esame tra il 1972 e il 1973. Con rilevazioni successive, in tutti questi soggetti sono stati valutati pressione arteriosa, glicemia, indice di massa corporea, funzione polmonare e renale, valori di colesterolo, solo per citare alcuni parametri. Le variazioni nel percorso di invecchiamento di questa popolazione, per quasi vent’anni, hanno in qualche modo offerto una misura delle “lancette” soggettive dell’invecchiamento. E’ nato così uno strumento di misurazione della velocità della via verso la senescenza. Ma soprattutto si è creato uno strumento (DunedinPacni) che è stato addestrato per stimare questo punteggio di invecchiamento utilizzando solo le informazioni provenienti da una singola risonanza magnetica (Rm) cerebrale, raccolta da 860 partecipanti allo studio Dunedin all’età di 45 anni. Questa osservazione è stata poi confrontata con quella derivante da scansioni Rm di persone di altre nazioni.
Il valore dell’algoritmo
Analizzando tutti questi dati, gli esperti hanno visto che chi invecchiava più rapidamente sotto il profilo biologico, quindi oltre l’età anagrafica, presentava risposte meno efficienti nei test cognitivi e soprattutto all’Rm metteva in luce un restringimento più rapido dell’ippocampo, con evidenti possibili ripercussioni sulla memoria, oltre ad avere un maggior rischio di declino cognitivo negli anni successivi. In questo senso, il confronto con altre popolazioni è stato di grande aiuto. Gli studiosi, come riporta lo studio, hanno infatti testato l’approccio analizzando le scansioni cerebrali di 624 individui di età compresa tra 52 e 89 anni, provenienti da uno studio nordamericano sul rischio di Alzheimer. E hanno visto che quando l’algoritmo ha supposto chi invecchiava più rapidamente al momento dell’adesione allo studio, questi avevano il 60% di probabilità in più di sviluppare demenza negli anni successivi. Inoltre, hanno iniziato ad avere problemi di memoria e di pensiero prima di coloro che invecchiavano più lentamente. Insomma, lo studio rivela pesanti rapporti tra corpo e cervello.
Come se non bastasse, la ricerca indica anche come chi aveva punteggi DunedinPacni peggiori non aveva solamente un maggior rischio di problemi neurodegenerativi, ma anche di patologie cardiovascolari o respiratorie. Le persone con una curva di invecchiamento più rapida avevano il 18% di probabilità in più di ricevere una diagnosi di una malattia cronica entro i successivi anni rispetto alle persone con un tasso di invecchiamento medio.
L’aiuto dell’Ai
L’analisi della scansie Rm, grazie a un algoritmo che pare superare quanto possono offrire i soli semplici parametri biologici e test cognitivi, può quindi diventare uno strumento per definire l’età biologica cerebrale e non solo. Partendo da questo dato, infatti, si potrebbero stimare i rischi di cronicità (non solo neurologici) negli anni a venire proponendo anche percorsi di prevenzione mirati, con stili di vita e altri approcci. Non dobbiamo infatti pensare che il tempo che passa imponga variazioni solo sulla base di quanto scritto nel Dna. Oltre alla genetica, la predisposizione ad invecchiare bene, cioè ad avere un’età biologica inferiore rispetto a quella anagrafica, pare dipendere soprattutto dalle abitudini. Se l’anagrafe non lascia scampo, quindi, si può puntare a “rubare” qualche anno sfruttando la buona qualità dell’organismo e delle strutture che lo formano. Considerando che, a prescindere dagli strumenti di misurazione, stili di vita sani possono aiutare a modificare la curva dell’orologio biologico più o meno accelerato di ognuno
L’importanza dell’imaging per il futuro
Pur se ci vorrà ancora tempo per far evolvere DinedinPacni, come rileva il primo autore dello studio Ethan Whitman in una nota dell’Università, questa modalità d’approccio potrebbe rivelarsi utile anche per spiegare l’impatto delle carenze di sonno o di quadri intercorrenti di ansia o depressione che potrebbero interferire sul processo di senescenza. D’altro canto, l’impiego della Rm non rappresenta il solo tentativo per definire l’età biologica del soggetto. Pensate che solo qualche tempo fa una ricerca ha messo in luce quanto una semplice lastra al torace potrebbe essere di supporto in questo senso.
Lo studio è stato condotto dagli esperti dell’Università Metropolitana di Osaka ed è apparso su The Lancet Healthy Longevity. Gli studiosi, coordinati da Yasuhito Mitsuyama e Daiju Ueda, hanno messo a punto un sistema di Intelligenza artificiale capace di stimare precisamente l’età reale di un soggetto partendo appunto dalle radiografie di un gran numero di persone. Non solo. La ricerca consente anche di calcolare quello che può essere l’impatto di una malattia cronica sull’età biologica (ovviamente non anagrafica) di un malato. In particolare lo studio di una grande quantità di immagini radiografiche ha infatti fatto rilevare come il sistema di Intelligenza artificiale riesca a percepire e calcolare anche la presenza di diverse condizioni patologiche, dall’ipertensione alla Bpco, la broncopneumopatia cronica ostruttiva. L’obiettivo futuro è arrivare a sviluppare biomarcatori in grado di far prevedere l’aspettativa di vita, stimare la gravità delle malattie croniche e preconizzare i rischi correlati a un eventuale intervento chirurgico.
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