Health
Blood tests for Alzheimer's may be coming to your doctor's office: What to know
- New blood tests show promise for faster and more accurate diagnosis of Alzheimer’s disease, medical researchers say.
- Many current Alzheimer’s diagnoses are based on symptoms and cognitive exams, but blood tests could offer a simpler alternative.
- Blood tests measuring p-tau217, a biomarker associated with Alzheimer’s, are expected to become more prominent as FDA guidelines are established.
New blood tests could help doctors diagnose Alzheimer’s disease faster and more accurately, researchers reported Sunday – but some appear to work far better than others.
It’s tricky to tell if memory problems are caused by Alzheimer’s. That requires confirming one of the disease’s hallmark signs — buildup of a sticky protein called beta-amyloid — with a hard-to-get brain scan or uncomfortable spinal tap. Many patients instead are diagnosed based on symptoms and cognitive exams.
Labs have begun offering a variety of tests that can detect certain signs of Alzheimer’s in blood. Scientists are excited by their potential but the tests aren’t widely used yet because there’s little data to guide doctors about which kind to order and when. The U.S. Food and Drug Administration hasn’t formally approved any of them and there’s little insurance coverage.
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“What tests can we trust?” asked Dr. Suzanne Schindler, a neurologist at Washington University in St. Louis who’s part of a research project examining that. While some are very accurate, “other tests are not much better than a flip of a coin.”
A doctor points to PET scan results that were part of a study on Alzheimer’s disease at Georgetown University Hospital, on May 19, 2015, in Washington. New blood tests could help doctors diagnose Alzheimer’s disease faster and more accurately, researchers reported on Sunday. (AP Photo/Evan Vucci, File)
Demand for earlier Alzheimer’s diagnosis is increasing
More than 6 million people in the United States and millions more around the world have Alzheimer’s, the most common form of dementia. Its telltale “biomarkers” are brain-clogging amyloid plaques and abnormal tau protein that leads to neuron-killing tangles.
New drugs, Leqembi and Kisunla, can modestly slow worsening symptoms by removing gunky amyloid from the brain. But they only work in the earliest stages of Alzheimer’s and proving patients qualify in time can be difficult. Measuring amyloid in spinal fluid is invasive. A special PET scan to spot plaques is costly and getting an appointment can take months.
Even specialists can struggle to tell if Alzheimer’s or something else is to blame for a patient’s symptoms.
“I have patients not infrequently who I am convinced have Alzheimer’s disease and I do testing and it’s negative,” Schindler said.
New study suggests blood tests for Alzheimer’s can be simpler and faster
Blood tests so far have been used mostly in carefully controlled research settings. But a new study of about 1,200 patients in Sweden shows they also can work in the real-world bustle of doctors’ offices — especially primary care doctors who see far more people with memory problems than specialists but have fewer tools to evaluate them.
In the study, patients who visited either a primary care doctor or a specialist for memory complaints got an initial diagnosis using traditional exams, gave blood for testing and were sent for a confirmatory spinal tap or brain scan.
Blood testing was far more accurate, Lund University researchers reported Sunday at the Alzheimer’s Association International Conference in Philadelphia. The primary care doctors’ initial diagnosis was 61% accurate and the specialists’ 73% — but the blood test was 91% accurate, according to the findings, which also were published in the Journal of the American Medical Association.
Which blood tests for Alzheimer’s work best?
There’s almost “a wild West” in the variety being offered, said Dr. John Hsiao of the National Institute on Aging. They measure different biomarkers, in different ways.
Doctors and researchers should only use blood tests proven to have a greater than 90% accuracy rate, said Alzheimer’s Association chief science officer Maria Carrillo.
Today’s tests most likely to meet that benchmark measure what’s called p-tau217, Carrillo and Hsiao agreed. Schindler helped lead an unusual direct comparison of several kinds of blood tests, funded by the Foundation for the National Institutes of Health, that came to the same conclusion.
That type of test measures a form of tau that correlates with how much plaque buildup someone has, Schindler explained. A high level signals a strong likelihood the person has Alzheimer’s while a low level indicates that’s probably not the cause of memory loss.
Several companies are developing p-tau217 tests including ALZpath Inc., Roche, Eli Lilly and C2N Diagnostics, which supplied the version used in the Swedish study.
Who should use blood tests for Alzheimer’s?
Only doctors can order them from labs. The Alzheimer’s Association is working on guidelines and several companies plan to seek FDA approval, which would clarify proper use.
For now, Carrillo said doctors should use blood testing only in people with memory problems, after checking the accuracy of the type they order.
Especially for primary care physicians, “it really has great potential to help them in sorting out who to give a reassuring message and who to send on to memory specialists,” said Dr. Sebastian Palmqvist of Lund University, who led the Swedish study with Lund’s Dr. Oskar Hansson.
The tests aren’t yet for people who don’t have symptoms but worry about Alzheimer’s in the family — unless it’s part of enrollment in research studies, Schindler stressed.
That’s partly because amyloid buildup can begin two decades before the first sign of memory problems, and so far there are no preventive steps other than basic advice to eat healthy, exercise and get enough sleep. But there are studies underway testing possible therapies for people at high risk of Alzheimer’s, and some include blood testing.
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A new test could make it easier to detect high-risk prostate cancer cases earlier.
The blood test, called Stockholm3, is showing promise in clinical trials, beating out the traditional, standard prostate-specific antigen (PSA) test.
In a new study published in the Annals of Internal Medicine, researchers from the Karolinska Institutet in Sweden studied the test’s efficacy in more than 12,000 men — mostly Swedish or European — aged 50 to 74.
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All participants were tested with PSA and Stockholm3 and were followed for two years. During the follow-up period, 443 men were diagnosed with aggressive prostate cancer.
Stockholm3 detected 90% of aggressive prostate cancer cases compared to 74% for PSA tests.
Stockholm3 detected 90% of aggressive prostate cancer cases compared to 74% for PSA tests. (iStock)
Stockholm3 missed “significantly fewer” serious cancer cases than PSA. The number of men incorrectly classified as high-risk was similar across both tests, according to a press release.
Thorgerdur Palsdottir, a researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, wrote in a statement that one of the major challenges in prostate cancer is being able to identify the cases that are “truly dangerous.”
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“Our results show that Stockholm3 identifies significantly more aggressive cancer cases than PSA without increasing the number of unnecessary follow-ups,” she said.
“These results point toward a potential change in how prostate cancer screening can be conducted,” the researcher added. “A more precise blood test could enable earlier detection of aggressive disease while reducing the number of unnecessary follow-up examinations and procedures.”
“A more precise blood test could enable earlier detection of aggressive disease while reducing the number of unnecessary follow-up examinations and procedures,” a researcher commented. (iStock)
Study co-author Hari Vigneswaran, chief medical officer of Stockholm3-maker A3P Biomedical, commented on these “promising” findings in an interview with Fox News Digital.
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He confirmed that the PSA has been the standard for prostate cancer screening since the 1990s despite its “well-documented limitations.”
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“It leads to invasive and costly follow-up testing, contributes to over-diagnosis of non-aggressive cancers and, most importantly, it misses a substantial share of aggressive disease,” Vigneswaran said.
When aggressive prostate cancer is found while still confined in the prostate, the five-year survival is close to 100%. (iStock)
When aggressive prostate cancer is found while still confined in the prostate, the five-year survival rate is close to 100%, which highlights the importance of early detection, according to the doctor.
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Data from the National Cancer Institute’s SEER database show that metastatic prostate cancer has risen over the past decade, suggesting that “we have not improved early detection of the aggressive, curable disease that screening is meant to catch,” Vigneswaran said.
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“The goal of screening is to find the cancers that need treatment while they are still curable, without raising the number of men who screen positive but don’t have aggressive disease,” he said.
Stockholm3 could reduce the need for unnecessary MRIs and biopsies, according to the researcher. (Getty Images)
Stockholm3 could reduce the need for unnecessary MRIs and biopsies, according to the researcher.
The findings did have some limitations. Stockholm3 is an investigational device and is not available for sale in the U.S., Vigneswaran noted.
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The test estimates a man’s risk of aggressive prostate cancer, but a biopsy remains the gold standard for confirming the disease.
The company plans to seek FDA approval to use the test for routine screening and will “generate the evidence needed to support that pathway, including U.S. data,” Vigneswaran said.
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Scientists have linked eating leafy green vegetables such as spinach, kale and broccoli to better lung health.
There are two primary forms of vitamin K found in foods. The primary kind is vitamin K1, found mainly in vegetables, which plays a major role in the body’s blood-clotting process.
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Vitamin K2 is found in fermented foods, certain dairy products, eggs and meats and helps regulate calcium in the body and supports bone health.
Researchers at Australia’s Edith Cowan University examined whether dietary intake of vitamins K1 and K2 was associated with chronic obstructive pulmonary disease (COPD), asthma and lung function.
Leafy green vegetables are high in vitamin K1, a nutrient that researchers have observed conributes to improved lung health. (iStock)
“Chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD) and asthma, are among the most prevalent noncommunicable diseases worldwide and were the third leading cause of death in 2019, accounting for 4 million deaths and affecting 454.6 million individuals globally,” the scientists reported in the introduction to their study, published in The American Journal of Clinical Nutrition.
“Although asthma and COPD can be managed with available treatments, neither condition is curable, underscoring the need for effective prevention strategies,” they added.
The leading cause of COPD is smoking, the Mayo Clinic reported. Exposure to other irritants, such as dust, chemicals and pollution, can also cause it.
The researchers analyzed data from 179,062 participants over a 10-and-a-half-year period and concluded that, “Higher dietary vitamin K1 intake was associated with better lung function and a lower rate of COPD.”
Researchers found that people who increased their vitamin K1 intake were less likely to develop COPD. (iStock)
Participants who consumed the most vitamin K1 had a 16% lower likelihood of COPD, the researchers observed. The effects were more pronounced in smokers and participants with high-risk occupations.
Consumption of vitamin K2 did not result in lower COPD rates.
“No association was observed for vitamin K1 or vitamin K2 intakes and asthma,” the researchers also wrote.
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Associate Professor Marc Sim, who was involved in the study, said that it’s likely Vitamin K activates a protein that may help keep lung tissue flexible and prevent damage.
Because the study was observational, it cannot prove that vitamin K1 directly reduces COPD risk, only that higher intake was associated with better lung health.
Researchers have associated higher consumption of leafy green vegetables with better lung function. (iStock)
Just one extra serving of leafy greens “is an achievable way to boost your vitamin K1 intake,” said Chengfeng Li, one of the study’s researchers.
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Other foods rich in vitamin K1 include collard greens, Swiss chard, Brussels sprouts and turnip greens.
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