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March 19, 2014

Blood test predicts Alzheimer’s risk

gloved hand holding vial of bloodA  study involving Rochester-area seniors has yielded the first accurate blood test that can predict who is at risk for developing Alzheimer’s disease. The discovery—which appears in the journal Nature Medicine—could be the key to unlocking a new generation of treatments that seek to head off the disease before neurological damage becomes irreversible.

The biomarker—which consists of 10 specific lipids found in blood plasma—predicted with greater than 90 percent accuracy which individuals would go on to develop Alzheimer’s disease or a precursor condition known as amnestic mild cognitive impairment. The cost of the simple blood test required to detect these lipids is a fraction of other techniques, and, unlike alternatives, it identifies risk early in the disease process before cognitive symptoms appear.

“The ability to identify individuals who are at risk of developing Alzheimer’s before the clinical manifestation of cognitive impairment has long been a Holy Grail of the neuromedicine community,” says Mark Mapstone, associate professor of neurology at the School of Medicine and Dentistry and lead author of the study. “Current efforts to develop a treatment for this disease are coming up short because they are probably being used too late. Biomarkers that can allow us to intervene early in the course of the disease could be a game changer.”

Alzheimer’s research is at an impasse with many once promising experimental therapies failing in late-stage clinical trials. These setbacks have led all but a few major pharmaceutical companies to pull back from their research and development in the disease.

By 2050, an estimated 14 million Americans will have Alzheimer’s, consuming an estimated $1.2 trillion in health care costs per year.

There is an emerging scientific consensus that once the cognitive symptoms of Alzheimer’s have emerged, it may be too late to slow or reverse the neurological damage caused by the disease. Researchers speculate that if treatments could be initiated early in the disease cycle, they may stand more of a chance of being effective. In fact, many of the same experimental treatments that have failed in recent clinical studies may ultimately prove to be successful if they are given to patients sooner. The challenge is that there currently exists no way to identify which people are at risk of developing Alzheimer’s.

There are several screening methods that can detect Alzheimer’s disease, such as spinal taps and advanced imaging systems such as MRIs, PET scans, and functional MRIs. But the techniques have significant limitations: they have only been shown to be effective in confirming a diagnosis of the disease after the cognitive symptoms have surfaced. Also, the high cost associated with the technologies is a significant barrier to widespread use in clinical practice.

“Having a tool that is able to identify, with a high degree of accuracy and at a low cost, which individuals will convert to Alzheimer’s could transform how we care for this devastating disease,” says Mapstone.

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