- Recent advancements in blood tests hold promise for quicker and more precise Alzheimer’s disease diagnosis, according to medical researchers.
- Currently, many Alzheimer’s diagnoses rely on symptoms and cognitive assessments, but blood tests could provide a less complicated option.
- Blood tests that assess p-tau217, a biomarker linked to Alzheimer’s, are anticipated to become more significant as FDA regulations are established.
New blood tests may enable physicians to diagnose Alzheimer’s disease more swiftly and accurately, as reported by researchers on Sunday – although some seem to perform significantly better than others.
Identifying whether memory issues stem from Alzheimer’s can be challenging. This typically requires confirming one of the disease’s signature indicators—the accumulation of the sticky protein beta-amyloid—through a difficult brain scan or an uncomfortable spinal tap. Consequently, many patients receive a diagnosis based on their symptoms and cognitive tests.
Various labs have started providing tests that can identify signs of Alzheimer’s through blood samples. While scientists are optimistic about their potential, these tests aren’t in widespread use due to a lack of definitive data to guide physicians on their selection and timing. Currently, the U.S. Food and Drug Administration has not officially authorized any of these tests, and insurance coverage remains limited.
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“Which tests are reliable?” queried Dr. Suzanne Schindler, a neurologist from Washington University in St. Louis, who is involved in a research endeavor examining this issue. While some tests exhibit high accuracy, “others don’t perform significantly better than random chance.”
A physician points to PET scan results from a study on Alzheimer’s disease at Georgetown University Hospital on May 19, 2015, in Washington. Researchers reported on Sunday that new blood tests could facilitate quicker and more accurate Alzheimer’s diagnoses.
(AP Photo/Evan Vucci, File)
Demand for earlier Alzheimer’s diagnoses is rising
Over 6 million individuals in the United States, along with millions more globally, suffer from Alzheimer’s, the most prevalent form of dementia. Its prominent “biomarkers” include amyloid plaques that clog the brain and abnormal tau proteins that result in neuron-destructive tangles.
New medications, Leqembi and Kisunla, can moderately slow the progression of symptoms by clearing amyloid deposits from the brain. However, they are effective only in the initial stages of Alzheimer’s, and determining patient eligibility in time can prove challenging. Testing spinal fluid for amyloid is invasive, while the specialized PET scan to detect plaques is expensive and scheduling appointments can take months.
Even specialists can find it difficult to ascertain whether Alzheimer’s or an alternative condition is the cause of a patient’s symptoms.
“I frequently encounter patients whom I firmly believe have Alzheimer’s, but test results return negative,” noted Schindler.
New study indicates blood tests for Alzheimer’s can be more straightforward and efficient
Blood tests have primarily been utilized in rigorously controlled research environments. However, a recent study involving approximately 1,200 patients in Sweden demonstrates that they can also function effectively in the hectic atmosphere of doctors’ offices—particularly among primary care providers, who often see a larger volume of patients with memory concerns yet possess fewer evaluation tools.
In the study, patients visiting either a primary care physician or a specialist for memory-related complaints underwent traditional diagnoses, provided blood samples for testing, and were referred for spinal taps or brain scans for confirmation.
According to researchers from Lund University, blood testing proved to be significantly more accurate. The primary care doctors had an initial diagnostic accuracy of 61%, while specialists had a percentage of 73%. In contrast, the blood tests boasted an accuracy of 91%, as shared in the findings presented at the Alzheimer’s Association International Conference in Philadelphia and published in the Journal of the American Medical Association.
Which blood tests for Alzheimer’s are the most effective?
There’s almost “a wild West” scenario regarding the variety of tests available, commented Dr. John Hsiao from the National Institute on Aging. These tests assess different biomarkers in diverse manners.
Doctors and researchers should exclusively utilize blood tests that demonstrate over 90% accuracy, advised Maria Carrillo, chief science officer at the Alzheimer’s Association.
Currently, tests most likely to meet this criterion evaluate what is termed p-tau217, a conclusion agreed upon by both Carrillo and Hsiao. Schindler was instrumental in conducting a notable direct comparison of various blood tests, which was funded by the Foundation for the National Institutes of Health, and reached the same conclusion.
This type of testing measures a variation of tau that correlates with the amount of plaque buildup in an individual, explained Schindler. Elevated levels signify a high probability of Alzheimer’s, whereas low levels suggest that memory loss is likely not related to the disease.
Numerous companies are in the process of developing p-tau217 tests, including ALZpath Inc., Roche, Eli Lilly, and C2N Diagnostics, which provided the test utilized in the Swedish study.
Who should utilize blood tests for Alzheimer’s?
Only licensed medical professionals can order these tests from laboratories. The Alzheimer’s Association is in the process of developing guidelines, and several companies intend to seek FDA approval, which would clarify appropriate usage.
For the time being, Carrillo stated that doctors should apply blood testing solely for individuals experiencing memory issues, ensuring they verify the accuracy of the specific type ordered.
Especially beneficial for primary care doctors, “this testing holds tremendous promise in helping them distinguish who can be reassured and who should be referred to memory specialists,” emphasized Dr. Sebastian Palmqvist of Lund University, who, along with Dr. Oskar Hansson, spearheaded the Swedish study.
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The tests are not recommended for individuals without symptoms who are merely concerned about a family history of Alzheimer’s—unless it involves participation in research studies, stressed Schindler.
This is partly due to the fact that amyloid accumulation can initiate two decades prior to the emergence of memory problems, and at this time, no preventive measures are available other than basic guidance to maintain a healthy diet, engage in regular exercise, and ensure adequate sleep. However, studies are underway to test potential therapies for individuals at high risk for Alzheimer’s, some of which involve blood testing.
