A test to predict Alzheimer's disease a decade before symptoms appear

A test to predict Alzheimer's disease a decade before symptoms appear

BarcelonaFor some time, science has been searching for ways to predict the prognosis of dementias such as Alzheimer's disease. Currently, these diseases are usually detected when a patient already has symptoms, meaning that by the time they visit and seek help, their condition is advanced and treatment alternatives – there are few drugs under study that have received regulatory approval – remain more limited. Now researchers at Shanghai University have taken a step forward to have a tool based on a blood test – one of the scientific community's bets in early detection of various diseases – to be able to predict up to a decade before the patient will have neurodegenerative diseases.

Key to this finding are four biological markers, i.e. patterns of blood plasma proteins, which are suspected to have links to the development of dementia. These are GFAP, NEFL, GDF15 and LTBP2. A study published Monday in the journal Aging nature The researchers analyzed data from 52,645 adults without dementia from the UK Biobank's Total Biomedical Data Project. This data was collected between 2006 and 2010. The researchers followed 1,417 participants who were eventually diagnosed with dementia for an average of 14 years. Of these, more than half (833) developed the disease after the first 10 years, as detailed in the journal.

Based on these findings, scientists developed a predictive risk model and found that high levels of the proteins GFAP, NEFL, GDF15 and LTBP2 indicate the risk of developing Alzheimer's disease and dementia. For example, inflammation in the brain can cause cells called astrocytes to overproduce GFAP, a protein that researchers say has high prognostic value. This pattern begins to change a decade before diagnosis, and people with high levels of this protein were twice as likely to develop dementia as those with lower levels. On the other hand, NEFL is associated with nerve fiber damage and GDF15 is associated with blood vessel damage in the brain.

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If this tool is combined with traditional risk factors, such as age, sex and genetic susceptibility, protein profiles allow disease risk to be estimated with an accuracy that, on paper, is up to 90% of cases. What is the importance of early detection of dementia and Alzheimer's? The researchers confirm that this will enable the identification of patients who could benefit from the two drugs that are still under review by the European Medicines Agency against the disease, which are lecanemab and donanemab.

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