Alzheimer's, Dementia & Mental Health
Blood Test, Spinal Fluid Analysis Both Find Success in Predicting Alzheimer’s Disease
Blood test successful 83% of time; spinal fluid biomarkers predict AD years in advance
July 20, 2011 - Progress
in an early detection of Alzheimer's disease (AD) was reported in two studies
presented today at the Alzheimer's Association International Conference (AAIC) in Paris. One is a blood test that has been successful 83% of
the time in determining high amyloid deposits in the brain, a marker of AD. The second used spinal fluid from patients with mild cognitive
impairment to identify biomarkers that predict AD years in advance.
One study uses blood measurements for estimating the amount of a toxic substance known as beta amyloid deposited in the
brain; the other study suggests that abnormal levels of certain proteins in cerebrospinal fluid (including beta amyloid) in people with mild
cognitive impairment may indicate who will develop Alzheimer's within the next 10 years.
Over Half of Alzheimer’s Cases May Be Preventable, Say Researchers
Study presented at Alzheimer's conference identifies key factors that can be modified to lower risk of AD - July 20, 2011
Finding Alzheimer’s Disease May be as Easy as Switching on a Light to See Amyloid Proteins
Rice U. lab's light-switching complex attaches itself to amyloid proteins, ‘lights up’ Alzheimer’s roots - see video
July 13, 2011
Alzheimer's Risk Gene Disrupts Brain's Wiring 50
Years Before Disease Hits Seniors
Whopping 88% of Caucasians have this clusterin gene; good news is it gives you 50 years to try to stop Alzheimer’s
and it's not most dangerous gene
May 26, 2011
Dementia, Mild Cognitive Impairment Common in
Rapidly Increasing 'Oldest Old' Women
Alzheimer's disease and mixed dementia account
about 80% of dementia cases; vascular dementia about 12.1%
May 9, 2011
Alzheimer’s Strikes First in Areas Where Cells 'Talk' Most; Boosts
deprivation and increased stress, which may affect Alzheimer’s risk, may also
increase activity levels in these vulnerable regions
May 2, 2011
New Guidelines for Alzheimer’s Diagnosis Starts with
Pre-Alzheimer’s, Marks Advances
Some older people have abnormal levels of amyloid
plaques, yet never show signs of dementia… amyloid deposits begin early
in the disease process but tangle formation, loss of neurons occur
later; new report for boomers, see below news story
April 19, 2011
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Alzheimer's, Dementia & Mental Health
Early detection of Alzheimer's – even before outward memory and thinking symptoms are evident – is very important as the
next generation of disease-modifying therapies are most likely to be effective if initiated during the earliest stages of the disease.
To that end, it is believed that build-up of a toxic molecule known as beta amyloid in the brain of people with
Alzheimer's occurs prior to cognitive decline. Thus, an accurate measurement or indicator of increased amyloid deposits in the brain could
possibly provide an earlier diagnosis compared to current methods of cognitive testing, and also possibly indicate the severity or progression
of the disease.
Estimating Amyloid Build-up in the Brain Using Blood Test
One of the stated objectives of the Australian Imaging, Biomarker and Lifestyle (AIBL) study is to find a prognostic
blood test for Alzheimer's, driven by the need for an early, cost effective and easily accessible screening test for the disease.
According to the AIBL scientists, an accurate indicator of increased levels of deposited amyloid in the brain holds the
possibility for early detection of Alzheimer's. They state that PET scans for brain amyloid, although powerful and informative about deposits
of amyloid in the brain, are not widely available and are considered too costly for widespread population screening.
Thus, they are generally reserved for research purposes. Spinal fluid amyloid measurements have been shown to correlate
with the amount of deposited amyloid in the brain; however, the procedure for obtaining spinal fluid is considered too invasive by some.
Samantha Burnham, PhD, CSIRO, Perth, Australia and colleagues in AIBL are working towards a more economic and accessible
blood-based alternative. To this end, AIBL scientists have been monitoring, over time, the blood chemistry, cognitive ability and lifestyle
factors of 768 healthy elderly people, 133 people with mild cognitive impairment (MCI) and 211 people with Alzheimer's.
They have also performed genetic and neuroimaging testing on 288 of the study participants.
The researchers found that a small group of blood measurements, including amounts of certain proteins and hormones,
correlated with the amount of deposited amyloid seen in the brain.
More specifically, they generated a model using nine blood-based markers (including Aβ1-42, ApoE, and cortisol) to
estimate the amount of deposited amyloid in the brain. With 83 percent sensitivity and 85 percent specificity, this estimate then determines
if an individual has an abnormally high amount of amyloid deposited in the brain, indicating risk of Alzheimer's.
The model was validated using a second cohort of 74 subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI).
For the ADNI validation study, measurements for two of the markers were unavailable; sensitivity and specificity of 76 percent were achieved.
"This model, if fully validated, may provide a means for assessing research outcomes for drug treatments and lifestyle
intervention strategies," Burnham said. "It may also lead to an effective and economical screen that indicates if an individual is in the
early stages of, or at risk of developing, Alzheimer's, and to justify further tests such as PET scans."
Measuring Amyloid in Cerebrospinal Fluid (CSF)
According to Henrik Zetterberg, MD, PhD, Department of Psychiatry and Neurochemistry, University of Gothenburg, Sweden
and colleagues, previous studies have shown that the Alzheimer's-related abnormal proteins found in CSF – known as Abeta42, total-tau and
phospho-tau – can accurate identify mild cognitive impairment (MCI) due to Alzheimer's up to 10 years before conversion to Alzheimer's
dementia. However, they say, it remains unclear exactly when these biomarkers turn positive.
To investigate this question, the scientists performed lumbar puncture on 137 people with MCI and clinically followed
them for more than nine years. During that time, 54 percent of the subjects developed Alzheimer's and 16 percent progressed to other forms of
The researchers found that:
● Baseline CSF Aβ42 levels were reduced and T-tau and P-tau were elevated in patients who converted to Alzheimer's
during follow-up period, as compared with non-converters (p< 0.0001).
● CSF Aβ42 levels were equally reduced at baseline in patients with MCI who converted to Alzheimer's within 0-5 years
(early converters) compared with those who converted to Alzheimer's between 5-10 years (late converters). However, CSF T-tau and P-tau were
significantly higher in the early converters compared with the late converters.
● A ratio of baseline Aβ42/P-tau predicted the development of AD within 9.2 years with a sensitivity of 88 percent,
specificity of 90 percent, positive predictive value of 91 percent and negative predictive value of 86 percent.
"In this study, we show that around 90 percent of MCI patients with pathological CSF biomarkers at baseline will develop
Alzheimer's within nine to 10 years," Zetterberg said. "Our results suggest that the CSF biomarker profile is highly predictive."
"We also found that CSF Aβ42 seems to be an earlier biomarker than CSF tau proteins. High CSF tau protein levels indicate
an intense neurodegenerative process and predict rapid progression to dementia. These biomarkers may be useful to select patients for early
intervention in clinical trials, and to identify and monitor treatment effects," Zetterberg said.
The Alzheimer's Association International Conference (AAIC) is the world's largest conference of its kind, bringing together researchers from
around the world to report and discuss groundbreaking research and information on the cause, diagnosis, treatment and prevention of
Alzheimer's disease and related disorders. As a part of the Alzheimer's Association's research program, AAIC serves as a catalyst for
generating new knowledge about dementia and fostering a vital, collegial research community.
About the Alzheimer's Association
The Alzheimer's Association is the world's leading voluntary health organization in Alzheimer care, support and research. Our mission is to
eliminate Alzheimer's disease through the advancement of research, to provide and enhance care and support for all affected, and to reduce the
risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer's. Visit
www.alz.org or call 800-272-3900.
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