‘Amazing, Isn’t It?’ Long Sought Blood Test for Alzheimer’s in Reach

A primer for newbies and old pros alike.
Fc1345linville
Contributor
Contributor
Posts: 99
Joined: Tue Feb 24, 2015 1:49 pm
Location: Washington DC area

‘Amazing, Isn’t It?’ Long Sought Blood Test for Alzheimer’s in Reach

Postby Fc1345linville » Tue Jul 28, 2020 11:26 am

Today's New York Times article, with link to the JAMA article for more details.



https://www.nytimes.com/2020/07/28/heal ... b2a761def9

User avatar
jenniferthequeen
Contributor
Contributor
Posts: 20
Joined: Wed Jul 22, 2015 5:38 am

‘Amazing, Isn’t It?’ Long Sought Blood Test for Alzheimer’s in Reach

Postby jenniferthequeen » Tue Jul 28, 2020 1:33 pm

Oh my.

circular
Senior Contributor
Senior Contributor
Posts: 5095
Joined: Sun Nov 03, 2013 10:43 am

Re: ‘Amazing, Isn’t It?’ Long Sought Blood Test for Alzheimer’s in Reach

Postby circular » Sat Aug 01, 2020 8:25 pm

Fc1345linville wrote:Today's New York Times article, with link to the JAMA article for more details.



https://www.nytimes.com/2020/07/28/heal ... b2a761def9

This appears to be a big breakthrough! Will be interesting to follow. Hopefully if it ultimately gets FDA approval it will funnel more people into clinical trials.
ApoE 3/4 > Thanks in advance for any responses made to my posts.

NF52
Support Team
Support Team
Posts: 1311
Joined: Tue Oct 25, 2016 9:41 am
Location: Eastern U.S.

Re: ‘Amazing, Isn’t It?’ Long Sought Blood Test for Alzheimer’s in Reach

Postby NF52 » Sun Aug 02, 2020 10:00 am

circular wrote:
Fc1345linville wrote:Today's New York Times article, with link to the JAMA article for more details.

https://www.nytimes.com/2020/07/28/heal ... b2a761def9

This appears to be a big breakthrough! Will be interesting to follow. Hopefully if it ultimately gets FDA approval it will funnel more people into clinical trials.
I agree Circular; this will make people who don't want a lumbar puncture for cerebral spinal fluid (CSF) (hand raised!) or would prefer to not have repetitive PET scans with radioactive tracers (also me) much more likely to sign up to be screened for clinical trials.

MANY researchers at last week's free, virtual Alzheimer's Association International Conference emphasized three important themes: Prevention, Risk Reduction and Preclinical Intervention. I'll highlight some of the findings in another post, but here's some big take-aways:

    *Prevention is a "Life Course Approach" in the words of one researcher. Everyone can and should seek to prevent AD regardless of genotype or family history, with different emphases at different ages and different risk profile. Prevention of Type 2 Diabetes was cited as one strongly supported prevention goal that requires both personal and public health efforts.
    *Risk Reduction or mitigation of risk is something those with familial or genetic risk or underlying health conditions should
    plan to do more deliberately. While earlier is better, it's NEVER TOO LATE at any age, and includes Preclinical AD (biomarker signs of amyloid beta and/or tau but no significant brain atrophy or cognitive impairment) and MCI. Intensive management of mid-life hypertension and coronary artery disease to prevent vascular damage was cited as one example of this, along with exercise and smoking cessation (4 years cessation even in late life reduces risk)

    *Together, Prevention and Risk Mitigation could prevent 40% of AD cases worldwide! This is a public policy and individual action mandate--which we on this forum have embraced.

    *Preclinical Intervention may prove to be necessary for the majority of people with high genetic risk, especially with positive results on blood tests like this one decades before outward signs of MCI or AD. In stark terms, from one presenter, women with ApoE 4/4 develop amyloid plaques 15-19 years earlier than men without ApoE 4. Once Aβ is "elevated" in someone with normal cognition, about 60-70% of these people may be diagnosed with MCI within 7-10 years. Once diagnosed with MCI in the presence of Aβ/tau, a majority currently are diagnosed with AD within 7 years after that. (Major gulp!!!)

    *GOOD NEWS: Some people in their 90's die with a brain full of Aβ and tau and no signs of dementia, possibly as many as 40% of people with ApoE 4/4; more with ApoE 3/4 and many more with ApoE 2/4.

    * An interesting finding for those frustrated with the long history of failed Aβ trials: * As many as one-third of people with a diagnosis of MCI or Alzheimer's enrolled in earlier anti-amyloid beta clinical trials did not have amyloid beta. Most of those "false AD diagnoses" had vascular dementia, or tauopathies like Parkinson's, Frontal-Temporal Dementias and Lewy Body dementia.

    *Multiple recent studies show that amyloid beta (Aβ) is likely to be a necessary, but not sufficient, stage of preclinical AD. Controlling Aβ, reducing it, preventing vascular brain risk in addition to Aβ and keeping synapses (brain connections) working and tau tangles from forming are all active and important areas of research ONCE THIS STAGE OF DISEASE IS REACHED. It may be one of the reasons aducanumab was most successful with ApoE 4/4 participants--aducanumab reduced both Aβ and tau in the brain--a result that amazed and encouraged researchers because it suggests that somehow getting rid of amyloid also reduces more dangerous "weeds" in the brain's garden (so to speak).

    * Clinical trials looking at anti-inflammatory effects (asthma medications!) and pro-synapse health as well as anti-tau are coming down the pike. IMHO, those at high risk and between 55 and 80 (myself included) need to consider whether we can safely join an online patient registry or enroll in screening for future options if prevention and mitigation is not enough.

    * Under-represented communities (racial and ethnic minorities, rural populations, people with limited access to primary health care, are often MORE at risk of Alzheimer's, yet less likely to be diagnosed and given support until a health or home crisis occurs. They are also very under-represented in clinical trials. Having a blood test which can be done at rural and diverse community settings to recruit under-served and under-researched groups is a win for them and society.

It seems unlikely that this will be a blood test you order from Lab Corp anytime soon. No one should be casually told "You have evidence of preclinical AD pathology" or "This blood test says you have Alzheimer's disease" without LOTS of careful thought on the ethics and need to do so.
4/4 and still an optimist!

User avatar
Julie G
Mod
Mod
Posts: 8534
Joined: Sat Oct 26, 2013 6:36 pm

Re: ‘Amazing, Isn’t It?’ Long Sought Blood Test for Alzheimer’s in Reach

Postby Julie G » Sun Aug 02, 2020 11:11 am

This appears to be a big breakthrough! Will be interesting to follow. Hopefully if it ultimately gets FDA approval it will funnel more people into clinical trials.

Agree, Circ. I think this test also has implications for getting people to a targeted program to address specific drivers even earlier increasing the odds of success.
It seems unlikely that this will be a blood test you order from Lab Corp anytime soon. No one should be casually told "You have evidence of preclinical AD pathology" or "This blood test says you have Alzheimer's disease" without LOTS of careful thought on the ethics and need to do so.

As usual, you bring up some really good points, NF52. I'm particularly concerned with the potential implications. While the Genetic Information Nondiscrimination Act protects against loss of medical insurance or employment, we have no such guarantees with a blood test for Alzheimer's which may pick up phospho-tau years before symptoms appear.

circular
Senior Contributor
Senior Contributor
Posts: 5095
Joined: Sun Nov 03, 2013 10:43 am

Re: ‘Amazing, Isn’t It?’ Long Sought Blood Test for Alzheimer’s in Reach

Postby circular » Sun Aug 02, 2020 1:10 pm

NF52 wrote:... aducanumab reduced both Aβ and tau in the brain--a result that amazed and encouraged researchers because it suggests that somehow getting rid of amyloid also reduces more dangerous "weeds" in the brain's garden (so to speak).

Thanks for that overview NF52.

In this video at Being Patient Rudi Tanzi describes (generally) a trajectory from Aβ > tau tangles > neuroinflammation and says that clinical symptoms appear at the neuroinflammation stage. So I would think anything safe to help identify and interrupt upstream Aβ and 'midstream' tau tangles could be useful.

This paper Rudi Tanzi was involved with showed, at least preliminarily, in a vacation and meditation intervention, that:
Highly significant gene expression changes were detected across all groups (the ‘vacation effect’) that could accurately predict (96% accuracy) between baseline and post-intervention states and were characterized by improved regulation of stress response, immune function and amyloid beta (Aβ) metabolism. [Emphasis added]
ApoE 3/4 > Thanks in advance for any responses made to my posts.


Return to “Getting Started”

Who is online

Users browsing this forum: No registered users and 8 guests