Blood Test Identifies Risk Of Disease Linked To Stroke And Dementia
MRI scans show the average measurable difference in white-matter brain damage in people with low inflammatory-blood-test scores and those with high scores . Image: Courtesy of Dr. Jason Hinman
Levels of six proteins in the blood can be used to gauge a persons risk for cerebral small vessel disease , a brain disease affecting an estimated 11 million older adults in the United States, a UCLA-led study has found. CSVD can lead to dementia and stroke, but currently it can be diagnosed only with an MRI scan of the brain.
The hope is that this will spawn a novel diagnostic test that clinicians can start to use as a quantitative measure of brain health in people who are at risk of developing cerebral small vessel disease, says Jason Hinman, MD , PhD, assistant professor of neurology.
CSVD is characterized by changes to the brains white matter the areas of the brain that have a high concentration of myelin, a fatty tissue that insulates and protects the long extensions of brain cells. In CSVD, small blood vessels that snake through the white matter become damaged over time, and the myelin begins to break down. This slows the communication between cells in the brain and can lead to problems with cognition and difficulty walking. If the blood vessels become completely blocked, it can cause a stroke. The disease also is associated with a heightened risk for multiple forms of dementia, including Alzheimers disease.
Sarah C.P. Williams
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Australian Research Could Help Other Neurological Conditions Too
This new research may not just help people with dementia. It could also assist in diagnosing other rare neurological conditions where brain cell death occurs.
Melbourne man Gary Wishart was first diagnosed with anxiety in 2014.
But his wife, Kath Lok, who is a GP, suspected there was more going on.
“He started seeing a psychiatrist and a psychologist for over 10 sessions, started on antidepressants, which made no difference. He just fell asleep,” she said.
It took years and dozens of tests for Mr Wishart to get answers. During that time, he was treated by at least 30 different doctors and specialists.
Dr Lok concedes it would be incredibly difficult to deal with getting a diagnosis for her husband if she did not have a medical background.
“If I didn’t push on and seek more advice, he’d probably have died,” she said.
Specialists now believe Mr Wishart has cerebral vasculitis, an incredibly rare neurological condition. Following an intense treatment period at the Royal Melbourne Hospital, he has started to recover.
“I feel quite amazing. I know that I’m not right, I’m not perfect. I’m not 100 per cent back to where I was,” Mr Wishart said.
His improvement means he can now help care for his two teenage sons again.
“I think for two or three years there, I probably didn’t have a husband. I was a carer. And when he started getting good treatment again, it took another two or three years for him to come back,” Dr Lok said.
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Blood Tests Available Now
A blood test is available now, through your doctor, that delivers a result in about 10 days and accurately determines whether someone has Alzheimers disease. The Preclivity AD Test from C2N Diagnostics measures proteins in blood plasma that indicate a buildup of plaques known to cause dementia in peoples brains.
Cost
The cost of this Alzheimers blood test is $1,250, less expensive than a PET scan that looks for the same protein buildups. Unfortunately, the price tag cannot be covered by Medicare or Medicaid, but C2N says people who cant afford the test can qualify for a discount based on their income.
Does it Work?
C2N Diagnostics says they tested Preclivity AD in 686 people and compared it to the results of PET scans. When PET scans showed a high amount of amyloid-beta, a protein that turns to plaques and tangles in the brains of people with Alzheimers, the blood test agreed 92 percent of the time. When the PET scan showed no amyloid, the blood test showed the same about 77 percent of the time.
How to Get the Blood Test
The Preclivity AD Test has not been approved by the Food and Drug Administration. It is currently available only through a doctor, and can be sold by the company under rules for commercial laboratories. The test, in other words, is available despite lacking FDA approval, though C2N has said the FDA is planning on reviewing the test in 2021. The Alzheimers Association says it wont endorse the test until there is FDA approval.
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Who Orders My Blood Tests
Your doctor typically orders blood tests for you during a physical, checkup, or an appointment intended for a specific condition.
Blood testing is usually partially or fully covered by insurance. Ordering tests through your medical provider ensures that youre not paying too much. Your doctor can also advise you on how to choose testing facilities that are reliable, well-managed, or convenient for you.
Its possible to order your own blood tests without a doctor or even health insurance, but its not recommended. You may end up paying the full cost by not going through an insurance plan, which can be expensive.
And some blood testing facilities may not give you accurate results. One infamous case of this is Theranos, a Palo Alto, California, biotechnology firm shut down in 2018 when an investigation uncovered lies and fraud around the accuracy of its private blood testing technology.
Normal levels can also vary by age.
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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Test Almost Usable In Routine Clinical Care
Dr. Palmqvist and team carried out two cross-sectional studies investigating the accuracy of the test in 842 participants and in an independent validation cohort of 237 participants .
Their studies revealed that the test accurately predicted cerebral -amyloid status in all stages of Alzheimer disease. Dr. Hansson says, e are starting to approach a level of accuracy that is usable in routine clinical care around the world.
Previous studies on methods using blood tests did not show particularly good results it was only possible to see small differences between and healthy people, says Dr. Palmqvist.
The researchers hope that the test will soon help clinicians screen potential participants in clinical drug trials for Alzheimers, or that it will help healthcare professionals diagnose Alzheimers more accurately and earlier on, thus improving peoples access to treatment and their overall outlook.
Using the test to prescreen participants for Alzheimers clinical trials would minimize the number of unnecessary lumbar punctures and PET scans, as well as lowering the costs for the examinations up to 3050%, depending on the cutoff, they write.
The next step to confirm this simple method to reveal beta-amyloid through blood sample analysis is to test it in a larger population where the presence of underlying Alzheimers is lower, adds Dr. Palmqvist.
‘the Diagnosis Has Been A Blessing For Us’
It was nearly eight years ago when Lisa Gye noticed something was not quite right with her husband, Darren Tofts.
“I just suspected that it was anxiety,” she said.
“And so I spent a lot of time trying to get him to see a psychologist. Because I thought a lot of the time when people are anxious, they become forgetful and they become a bit disorganised.”
For around 30 years, Mr Tofts was a professor of media and communications at Swinburne University.
At first, he suspected his stressful job was to blame for his anxiety. But after he retired, his condition worsened.
“At the time we didn’t know what was going on. Until we realised that something was going on ‘up here’,” he said.
It took around five years for Mr Tofts to be diagnosed with Alzheimer’s. He was only 57 at the time.
“When you’re not quite sure what’s going on, it can be quite frightening. And then when you do find out and know, well the fear perhaps goes away a bit,” Mr Tofts said.
Ms Gye believes any test that could help deliver an earlier diagnosis is invaluable for people with dementia and their families.
“Alzheimer’s is not just something that affects old people,” she said.
“Our quality of life has improved, it hasn’t gotten worse. It was bad before, because we didn’t know what was going on.”
Mr Tofts and Ms Gye have chosen to be open about his diagnosis.
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Alzheimers Blood Test Comes To The Clinic
Pauline Anderson
The first blood test to detect the presence of amyloid, a hallmark of Alzheimers disease , is now available for clinical use, the company behind the tests development, C2N Diagnostics, has announced. The availability of the noninvasive, easily administered test is being called a milestone in the early detection and diagnosis of AD.
The blood test introduces a new option for patients, families, and the medical community that have eagerly awaited innovative tools to address Alzheimers troubling problems, Joel B. Braunstein, MD, CEO of C2N Diagnostics, said in a press release.
This is really an important advance, said Howard Fillit, MD, founding executive director and chief science officer of the Alzheimers Drug Discovery Foundation , which partially funded the development of the test, in a separate press release.
You can now walk into your doctors office to get a blood test to help detect Alzheimers disease, said Fillit. This test answers a critical need for less costly and accessible diagnostic testing in memory and dementia care.
Is Dementia A Mental Illness
Dementia is a mental health disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders. In 2013, the American Psychiatric Association changed the name to Major Neurocognitive Disorder, which is a mouthful. The change was made in order to provide a clearer description of the problem. Whats most important to know is that dementias can involve changes to emotions, behaviors, perceptions, and movements in addition to memory and thinking.
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When Combined With Age And Genetic Risk Factor Test Is 94% Accurate
- Date:
- Washington University School of Medicine
- Summary:
- A blood test to detect the brain changes of early Alzheimer’s disease has moved one step closer to reality. Researchers report that they can measure levels of the Alzheimer’s protein amyloid beta in the blood and use such levels to predict whether the protein has accumulated in the brain. The findings represent a key step toward a blood test to diagnose people on track to develop the devastating disease before symptoms arise.
Up to two decades before people develop the characteristic memory loss and confusion of Alzheimer’s disease, damaging clumps of protein start to build up in their brains. Now, a blood test to detect such early brain changes has moved one step closer to clinical use.
Researchers from Washington University School of Medicine in St. Louis report that they can measure levels of the Alzheimer’s protein amyloid beta in the blood and use such levels to predict whether the protein has accumulated in the brain. When blood amyloid levels are combined with two other major Alzheimer’s risk factors — age and the presence of the genetic variant APOE4 — people with early Alzheimer’s brain changes can be identified with 94% accuracy, the study found.
When the researchers included these risk factors in the analysis, they found that age and APOE4 status raised the accuracy of the blood test to 94%. Sex did not significantly affected the analysis.
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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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Blood Tests Show Promise For Early Alzheimers Diagnosis
From NIH Research Matters
With the aging of the U.S. population, the incidence of Alzheimers disease continues to rise. The disease is currently the most common cause of dementia in older adults.
Brain changes associated with Alzheimers include abnormal clumps , tangled bundles of fibers , and the eventual death of nerve cells. These changes can lead to a progressive decline in memory and thinking skills.
Treatments dont yet exist to slow or reverse Alzheimers disease progression. Researchers are working to test new therapies in clinical trials. But no blood tests can currently diagnose Alzheimers before symptoms develop. This complicates studies of early treatments or preventive strategies.
PET imaging and tests that use cerebrospinal fluid can be used to identify Alzheimers before dementia develops. But PET imaging is expensive, and collecting CSF is invasive. Recent research found that measurements of a substance in the blood called ptau181 showed promise as an Alzheimers test.
Scientists have been examining whether another form of the tau protein, called ptau217, can also serve as an early marker of Alzheimers development. Both are found in the tau tangles that accumulate in the brain and can spill into the bloodstream. Two new studies tested different ways of measuring ptau217 in blood samples. The research teams were funded in part by NIHs National Institute on Aging , National Institute of Neurological Disorders and Stroke , and Office of the Director .
Blood Test May Spot Signs Of Early Alzheimer’s
By Robert Preidt HealthDay Reporter
THURSDAY, Aug. 1, 2019 — A simple blood test helped pinpoint the early signs of Alzheimer’s in a new study.
Up to two decades before people develop Alzheimer’s symptoms such as memory loss and confusion, harmful clumps of amyloid beta protein begin to accumulate in their brain, researchers explained.
But it’s possible to measure levels of amyloid beta in the blood and use that information to determine whether the protein has accumulated in the brain, they added.
Combining blood amyloid levels with two other major Alzheimer’s risk factors — age and the genetic variant APOE4 — can identify people who have early Alzheimer’s brain changes with 94% accuracy, according to the scientists from Washington University School of Medicine in St. Louis.
The study included 150 adults over age 50 who had no thinking or memory problems.
The blood test may be even more sensitive than the current gold standard — a PET brain scan — at detecting early amyloid accumulation in the brain, according to the authors.
The findings advance efforts to have a blood test to identify people who will develop Alzheimer’s before they have symptoms, and such a test could be available in doctors’ offices within a few years, the researchers said.
They added that the benefits of the blood test would be even greater once there are treatments to stop the progress of Alzheimer’s disease.
The study was published Aug. 1 in the journal Neurology.
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So Can A Blood Test Detect Alzheimers Disease
With many people a blood test often sends shivers down the spine. Especially when we think of needles and blood and a visit to the doctors. But if we are going to help prevent Alzheimers then a simple test could go a long way to helping prevent the chances of developing the disease in later life.
So what does the blood test involve. Well its not as bad as we first think. Blood is taken from the finger by way of a small lancet piercing the finger. A few droplets are then placed on the testing paper.The sample is then sent off for analysis and detection of any abnormalities and levels of high Homocysteine in the blood which could lead to developing Alzheimers in later life.