Enables Testing Of Drugs
But the test doesnt mean that society will immediately have a treatment for everyone, Fladby said. Instead, the test is an important step on the road to further research.
Being able to make early diagnoses and identify patients who have incipient problems is a necessary step in finding an effective treatment, Fladby said.
Thus, the next step could be to test treatment on at-risk patients, and compare the effect against control groups which can take many years.
Referral To A Specialist
If a GP is unsure about whether you have Alzheimer’s disease, they may refer you to a specialist, such as:
- a psychiatrist
- an elderly care physician
- a neurologist
The specialist may be based in a memory clinic alongside other professionals who are experts in diagnosing, caring for and advising people with dementia and their families.
There’s no simple and reliable test for diagnosing Alzheimer’s disease, but the staff at the memory clinic will listen to the concerns of both you and your family about your memory or thinking.
They’ll assess your memory and other areas of mental ability and, if necessary, arrange more tests to rule out other conditions.
Introduced In Sweden Last Year
The one blood test that the researchers developed has been in clinical use in Sweden since 2020. It measures NFL, a marker for nerve cell damage in the brain.
The other measures phosphorylated tau, a marker of changes in the brain that are specific to Alzheimer’s. Blennow expects this test to be approved for clinical use during 2021.
Its easy to send blood samples, and we also have the capacity to analyse samples from neighbouring countries such as Norway, says Blennow.
Blennow says its most relevant for a person to be tested if they notice that their memory is bad. Those who are tested can then be offered experimental treatment with promising drugs.
There are several different, promising drugs in development. One has been submitted for approval to the US Food and Drug Administration, he said.
Before these drugs can be used on a large scale in Norway and Sweden, however, they have to be approved by each country’s state drug agency.
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What Makes This New Blood Test Different Than Previous Attempts
Paulson: Our ability to detect signals in blood of specific proteins linked to disease has gotten better over time. This success is due to the fact that the technology is now much better and the specific biomarker being detected is closely linked to the underlying pathology of Alzheimers disease. That is why it seems so promising.
Coping With A Diagnosis
But a diagnosis of Alzheimers, or of being at risk of developing Alzheimers, can be a difficult one.
These patients will have an increased risk of developing dementia, but it is not a one hundred percent risk, and it can be affected, Fladby said.
Several studies have measured exactly how patients handle these kinds of difficult messages.
The results are uplifting most patients dont become depressed, but make changes that have to do with lifestyle. They become more social, spending time with family, Fladby said.
But healthcare professionals must exercise judgement and assess who can cope with this kind of diagnosis before they administer the test. They may want to exclude patients who already suffer from depression, Fladby said.
Translated by: Nancy Bazilchuk
References:
A. Moscoso et al.: Time course of phosphorylated-tau181 in blood across the Alzheimers disease. Summary Brain, 30 November 2020.
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What Have Previous Tests And Treatments Looked Like And Why Have They Been Unsuccessful
Paulson: The cerebrospinal fluid measurements are actually quite good at helping doctors make the diagnosis of Alzheimers versus another dementia, but the ordeal of undergoing a procedure that many patients are not eager to undergo means that cerebrospinal fluid measurements are not routinely used in clinical practice.
PET imaging of amyloid and tau is remarkably powerful, but, in the current absence of insurance coverage, most patients simply cannot afford it. Thus, for now, it remains a research test.
Treatments are another matter altogether. While anti-amyloid therapies continue to be tested, they have not been robustly positive in clinical trials. We dont yet know if that lack of effectiveness is due, perhaps, to giving the treatments too late or due to anti-amyloid treatments simply being insufficient as a therapy for Alzheimers.
A simple and sensitive blood test that could pinpoint the Alzheimers disease process well before any cognitive symptoms would allow us to give any potential disease-slowing therapy anti-amyloid, anti-tau, anti-inflammatory at a very early point in the disease process. Doing so likely will increase our chances of finding an effective therapy.
Assessment For Dementia Usually Includes The Following:
Personal history
The doctor usually spends some time discussing your medical history and gathering information about your changes in memory and thinking.
Physical examination and laboratory tests
The symptoms of dementia can be due to a number of other possible causes, such as vitamin deficiency, infection, metabolic disorders and side effects from drugs.
These other causes are often easily treated.
Therefore, an early step in diagnosing dementia is to rule out these causes through a physical examination, blood tests and urine tests.
Routine laboratory tests used in the diagnosis of dementia include:
- Blood tests to investigate:
- Drug interactions and dosing problems
Cognitive testing
Cognitive tests are used to measure and evaluate cognitive, or thinking, functions such as memory, concentration, visual-spatial awareness, problem solving, counting and language skills.
Most doctors use short cognitive screening tests when assessing these functions. If more detailed testing is required you will be referred to a neuropsychologist a psychologist specialising in the assessment and measurement of cognitive function.
Cognitive tests are vital in the diagnosis of dementia and are often used to differentiate between types of dementia. They can also be used to assess mood and may help diagnose depression, which can cause symptoms similar to those of dementia.
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Qplextm Alz Plus Assay
Quantamatrixs multiplex diagnostics platform was applied as previously described for the QPLEXTM kit with microdisk technology to analyze multiplexes in a single well. This system utilizes graphically coded beads that can expose antigens. In brief, diluted human plasma samples were incubated with the coded beads and antibodies in a 96-well plate. A 96-well plate was incubated in a shaking incubator at 1000rpm for 90min at RT. Coded beads, including immunocomplexes, were washed on a Biotek-510 magnetic wash station . Fifty microliters of diluted R-phycoerythrin-conjugated streptavidin were added to each well and incubated for 15min at RT. After incubation, the immunocomplexes were washed three times. Complexes were resuspended in 100l of washing buffer and analyzed.
How The Brain Changes With Alzheimers
Alzheimers is a complex disease that can not be diagnosed easily. Approximately 80% of dementia sufferers have Alzheimers. The early-arriving symptom of Alzheimers is short-term memory loss. An array of other cognitive and physical deterioration resulting from brain cell loss will gradually deteriorate over time. This major decline can cause individuals to lose their independent ability to live and relate to those around them.
The percentage of Americans with Alzheimers is large, reaching 5.8 million individuals and it is said that by 2050 numbers will increase to 14 million. Unfortunately, Alzheimers disease is not cured, but medications are available to relieve symptoms. Although there are no treatments to prevent the progression of this illness.
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Alzheimers / Dementia Testing Alternatives
Despite the lack of an FDA-approved blood test, families who suspect their loved one may have Alzheimers have a well-trod, if meandering, path to a diagnosis. To begin the process, there are online tests for Alzheimers that can be downloaded, printed, completed and taken to your doctor, and even some interactive tests that might provide immediate results. However, these online tests do not actually test for Alzheimers or dementia. Instead, they offer families answers to these questions: Are my concerns about my loved one justified?Is this just normal aging or is there something more going on? Officially, the tests are looking for Mild Cognitive Impairment . These tests are not definitive, but they can help a family figure out what their next step should be.
If a doctor suspects a patient may have Alzheimers, there are more definitive approaches. Brain scans and tests on extracted spinal fluid when coupled with multiple physicians consultations can make a diagnosis of Alzheimers with upwards of 90 percent accuracy. Families should expect their loved one to be evaluated by a neurologist, a psychiatrist, and very likely a psychologist as well. Since Alzheimers is so common among the elderly, a diagnosis is less about finding a condition which fits and more about eliminating other possibilities.
Nfl Levels Predict Symptoms 16 Years Ahead
Examination of the blood samples from the first visit revealed higher levels of NfL in those people who carried a gene mutation. In these individuals, repeated visits showed NfL levels rising over time.
The individuals who did not carry a gene mutation, however, did not show this pattern. Their NfL levels were lower and remained fairly steady over time.
The team detected the rise in NfL levels some 16 years before the anticipated onset of symptoms.
Results from the brain scans were in line with the changes in NfL levels.
The rate of increase in the protein matched the rate of thinning and shrinkage in the brains precuneus, which has a role in memory.
Schultz remarks that 16 years before symptoms arise is really quite early in the disease process, but we were able to see differences even then.
Further analysis revealed that NfL levels were also predictive for the decline in memory and thinking skills in the cognition tests.
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Existing Tests And Treatments Are Expensive
ABC News: Michael Vincent
For Matthew Kiernan, of the Brain and Mind Centre at Sydney University, this discovery is “a breakthrough”.
“It’s a diagnostic biomarker for the disease and that’s critically important in terms of taking the whole field forward and coming up with therapies for Alzheimer’s disease,” he said.
It could help doctors diagnose and even treat the disease decades before the symptoms appear.
“The majority of patients wouldn’t want to be on 20 years of therapy for no purpose,” Professor Kiernan said.
“The type of treatments we’re looking at, monoclonal antibodies, gene-related therapies, they are incredibly expensive surgery, putting patients on these therapies for potentially 20 to 25 years before they’re even symptomatic.”
Patients could then make critical lifestyle choices much earlier.
“There’s probably 10 to 15 reversible factors that can affect improve your outcomes with dementia,” Professor Kiernan said.
“Simple exercise engagement, monitoring blood pressure, not smoking, low blood sugars, and mental and physical engagement are critical for the outcomes of patients who have dementia today.”
Simple Blood Test May Be Able To Diagnose Alzheimers Disease
A simple blood test may soon be able to diagnose patients with two common forms of dementia Alzheimers disease and frontotemporal dementia and tell the two apart.
Researchers at UC San Francisco analyzed the blood test in more than 300 patients and say they hope to see such a test available in doctors offices within five years.
This test could eventually be deployed in a primary care setting for people with memory concerns to identify who should be referred to specialized centers to participate in clinical trials or to be treated with new Alzheimers therapies, once they are approved, said Adam Boxer, MD, PhD, neurologist at the UCSF Memory and Aging Center and senior author of the study published in Nature Medicine. Boxer also is affiliated with the UCSF Weill Institute for Neurosciences.
No blood test currently exists for either condition. Alzheimers diagnoses can only be confirmed by a PET scan of the brain, which can be costly, or an invasive lumbar puncture to test cerebrospinal fluid.
If approved, the new blood test could ease screening and help increase the number of patients eligible for clinical trials, which are essential to the search for drugs to stop or slow dementia. Patients who know whether they have Alzheimers or FTD are also better able to manage their symptoms, which may differ between the two conditions.
Adam Boxer, MD, PhD
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Dominantly Inherited Alzheimers Disease
In the new research, the team studied a rare form that has the name dominantly inherited Alzheimers disease , or autosomal dominant Alzheimers disease.
The data for the study came from the Dominantly Inherited Alzheimers Network , which is an international consortium that Washington University leads. The aim of the network is to investigate the causes of Alzheimers disease.
DIAD arises from a mutation in one or more of three genes: PSEN1, PSEN2, or APP.
People with DIAD typically experience memory loss and other symptoms of dementia in their 30s, 40s, and 50s.
The researchers chose to study people with DIAD because the earlier onset of the disease gives a longer timespan over which to investigate brain changes before cognitive symptoms emerge.
The analysis took in data on more than 400 people in the DIAN network. This number included 247 who were carriers of a genetic mutation and 162 of their blood relatives who were not carriers.
All the individuals had attended a DIAN clinic and given a blood sample, completed cognition tests of memory and thinking skills, and undergone brain scans. In addition, around half had made repeat clinic visits, with up to 3 years between each.
A Simple Blood Test That Can Detect The Early Brain Changes Leading To Dementia Would Really Revolutionise The Search For New Treatments And Our Funded Research Has Identified Changes In The Blood Of Those In The Earliest Stages Of Alzheimers
‘While the idea of an Alzheimers blood test feels like it has been around for decades, advances in technology over the last couple of years mean that it is now a becoming a reality, and fast. This is an incredibly exciting area of progress in dementia research.
‘But its important to note this isnt a blood test for dementia it tells us that amyloid deposits are in the brain, which are a hallmark of Alzheimers disease, but are also found in healthy older people too. This test will speed up dementia research by identifying those at risk of Alzheimers who might be suitable for clinical trials aimed at preventing or delaying the development of dementia. In the meantime, we’re eagerly awaiting the results of larger studies to validate this blood test.’
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Potential Breakthrough For Prevention And Treatment
Researchers hope that their findings lead to breakthroughs in treatment methods. Senior study author, Dr. Ed Goetzl, says:
My vision of the future is you have your breakfast cereal, and on one side you have a statin for cardiovascular disease and on the other side you have three pills to prevent dementia.
He went on to state that, This study shows that insulin resistance is a major central nervous system metabolic abnormality in Alzheimers disease that contributes to neural cell damage. As insulin resistance is a known condition in type 2 diabetes and is treatable with several classes of existing drugs, these treatments may be useful as part of a multi-agent program for Alzheimers.
The blood test is still in the early stages of development and will require a larger and longer study before it can be used to detect Alzheimers. The lead author of the study and neuroscientist at the National Institute on Aging, Dimitrios Kapagiannis, says: We will need replication and validation, but Im very optimistic this work will hold.
Do you think the newest blood test is a viable way to prevent Alzheimers disease? Please share your thoughts with us in the comments below.
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How Often Should I Get Routine Blood Work
Your doctor will typically recommend that you get routine blood work at least once a year, around the same time as your yearly physical.
But this is the bare minimum. There are several major reasons you may want to get blood tests more often than that:
- Youre experiencing unusual, persistent symptoms. These could include anything from fatigue to abnormal weight gain to new pain.
- You want to optimize your health. Knowing levels of various blood components, such as HDL and LDL cholesterol, can allow you to tweak your diet or fitness plan to minimize unhealthy habits . This can also maximize the nutrients you put in your body and more.
- You want to reduce your risk of disease or complications. Regular blood tests can catch the warning signs of almost any disease early. Many heart, lung, and kidney conditions can be diagnosed using blood tests.
Talk to your doctor first if you want to get certain tests more often than once a year.
- nutrient tests for levels of vital nutrients, such as iron or B vitamins
Some other tests that you may want include:
- enzyme markers if youre at risk for cancer or other conditions like liver cirrhosis, stroke, or celiac disease
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I Keep Forgetting What Im Doing Do I Have Dementia
Everyone occasionally loses their keys, or goes into a room and forgets why theyre there. It is also perfectly natural to mix up peoples names and sometimes forget appointments that youve made. These memory lapses often unfortunately become more frequent as we get older, or when we are busy or distracted. In all probability, they do not mean that you have Alzheimers, or any other type of dementia.
A good rule of thumb is that if you are worrying about your memory, and you noticing your own lapses as they come and go, then its unlikely you have dementia.