OT? Blood test for pre-Alzheimer's

Because Alzheimer’s disease has such a huge financial impact it may have Macroeconomic significance. In the United States, the total cost of caring for individuals with Alzheimer’s and other dementias is estimated at over $360 billion annually, and it is projected to top $1 trillion as the baby boomer generation fully ages.

CARDIA is a longitudinal study of over 5,000 people that started in 1985-6 with a group of 5115 Black and White men and women aged 18-30 years. Since that was 40 years ago, the cohort is now 58 to 70 years old. Factors with clear links to heart disease such as blood pressure, cholesterol and other lipids, and glucose were collected, along with physical measurements such as weight and body composition, as well as lifestyle factors such as dietary and exercise patterns, substance use (tobacco and alcohol), behavioral and psychological variables, medical and family history, and other chemistries (e.g., insulin). There’s a lot more detail at the link.

The link between Alzheimer’s Disease (AD) and cardiovascular problems is already well-established so the CARDIA researchers took took the opportunity to test a new biomarker blood test for AD in
CARDIA participants who have not been diagnosed with AD.

Alzheimer’s blood test around ages 53-69 may help detect early cognitive decline

  • Some current research has been focusing on how to identify the earliest signs of Alzheimer’s disease.

  • One tool that doctors are beginning to use to help predict a person’s Alzheimer’s disease risk in its earliest stages is through biomarker blood tests.

  • A new study has found that these biomarker blood tests may also help doctors find very early signs of cognitive decline in midlife adults without a dementia diagnosis.

  • Researchers believe that using biomarker blood tests in this way may lend greater credence to initiating healthy lifestyle modifications known to help lower dementia risk.


For the study, researchers analyzed data from participants of the U.S. Coronary Artery Risk Development in Young Adults (CARDIA) Study. Researchers selected about 1,300 of these study participants with an average age of 61.

Of this pool, 6% showed a high level of the proteins beta-amyloidTrusted Source and tau in their blood, which are considered hallmarks of Alzheimer’s disease.

Scientists found that the participants in this 6% had lower processing speeds and executive function. And when tested five years later, those with high beta-amyloid and tau biomarkers had about 2.5 to 4 times the risk of rapid decline in verbal memory, and around 3 to 4 times the risk of rapid decline in processing speed.… [end quote]

There isn’t a drug treatment for AD yet but when one is developed it would be more effective to treat people in the early stages than later when the damage is irreversible.

I was struck by the low number of people with the blood biomarkers - only 6%. At ages 65 to 74, around 5% of people have Alzheimer’s so that’s pretty close.
The risk climbs with age. For women at age 65, the lifetime risk of developing Alzheimer’s is about 1 in 5 (approx. 20%) but that may be because women live longer than men. For men at age 65, the lifetime risk is about 1 in 10 (approx. 10%).

The conclusion of the article is that getting a blood test that indicates pre-Alzheimer’s might motivate people to make healthy lifestyle changes that they should be doing anyway. It sure would be a gut punch to get a positive test and maybe that would wake some people up enough to take action.

Wendy

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Maybe. But if getting on the scale and looking in the mirror and buying clothes wasn’t enough of a gut punch, would a mere blood test with some gobbledegook percentages attached be one? And what about all the blood pressure tests and bloodwork that showed high glucose and high cholesterol? Were those blood tests not enough of a gut punch?

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That’s an interesting question/observation, Mark. One I’ve oftentimes asked myself over the years. People can be very strange and even when evidence of potential for harm …and even knowledge of that evidence… is right before their eyes, it seems to be easy to ignore if action is required that doesn’t comport with what folk believe.

You’ve chosen two biomarkers that, to ignore their potential for significance, is pure denialism and a lost opportunity for most to be proactive about disease prevention (yes, I know the bathroom scale, mirror and a handy tape measure can’t be beat…bear with me) I’ve pretty much beaten the value of aggressive lipid lowering in a susceptible population to death so I won’t go there again (have you started your statin yet?)

Not so long ago, I posted a link to an article on reclassification of “prediabetes” that advocated a shift from it being an “only” condition to early disease state. Seemed to me that this was a no brainer given the growing understanding of the pathophysiology of so many diseases and the relationship to insulin resistance as a primary driver. And yet…

OT…goodbye prediabetes? - Investment Analysis Clubs / Macro Economic Trends and Risks - Motley Fool Community OT....goodbye prediabetes? - Macro Economic Trends and Risks - Motley Fool Community

Now, I wouldn’t expect anyone to rush out to get a circulating insulin test with an A1c around 5.4 as I did … even though it might well be an eye opener for the earliest stages of metabolic dysfunction…but it’s obvious that recognition of prediabetes as a driver of disease in and of itself and therefore worthy of intervention has a long way to go.

It’s a head scratcher, alright.

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