Researchers have made a big step toward a blood test that could tell if someone might get dementia more than ten years before doctors usually spot it.
They got hopeful after finding signs of dementia in blood samples from over 50,000 healthy people in the UK Biobank project.
By looking at the blood, they found four proteins that could predict dementia, including Alzheimer’s disease and vascular dementia, which are types of dementia in older people.
When they looked at these proteins together with things like age, sex, education, and genetics, they could guess if someone might get dementia with about 90% accuracy, nearly 15 years before they actually got it.
More than 55 million people around the world have dementia, and this might go up to 78 million by 2030. Alzheimer’s disease causes about 70% of dementia cases, while vascular dementia, caused by damaged blood vessels, makes up about 20%.
Prof Jianfeng Feng, from the University of Warwick and Fudan University in China, said they hoped to make a test kit for the NHS.
Lots of recent studies have shown that blood tests could help find people who might get dementia. This could help doctors decide who needs more tests to check if they have Alzheimer’s.
Finding out early is important if patients are going to benefit from two new Alzheimer’s drugs, lecanemab and donanemab. These drugs are being checked by the UK medicines regulator. If they are allowed, the National Institute for Health and Care Excellence will look at whether they are worth the cost before deciding if they should be used in the NHS.
The US medicines regulator has approved lecanemab and is about to decide on donanemab. European regulators are still checking both drugs.
Doctors and medical charities have warned that the NHS might not be ready to give out these drugs yet.
To get lecanemab or donanemab, patients need to have early Alzheimer’s and a lumbar puncture or a PET scan to check for amyloid protein in the brain. Only about 2% of people who could have these tests get them.
People are trying to make simple blood tests to find Alzheimer’s, but even if we can find it quickly, there are still problems. Patients need to get the new drugs put into their blood every two weeks. And because the drugs might have serious side effects, patients need regular MRI scans to check if there are problems in their brain.
In the latest study, scientists looked at blood from 52,645 adults in the UK who didn’t have dementia. They kept the blood frozen for 10 to 15 years and then looked at it again. More than 1,400 people in the study got dementia later.
Using artificial intelligence, the researchers found four proteins, Gfap, Nefl, Gdf15, and Ltbp2, that were different in people who got dementia.
Having higher levels of these proteins could mean someone might get dementia. When there’s inflammation in the brain, cells called astrocytes make too much Gfap, which shows that someone might get Alzheimer’s. People with more Gfap were more than twice as likely to get dementia.
Another protein, Nefl, shows if there’s damage to nerve fibers. If there’s more Gdf15 than normal, it might mean there’s damage to the brain’s blood vessels. And having more Gfap and Ltbp2 might show dementia instead of other brain problems. These changes could happen at least 10 years before someone gets a dementia diagnosis.
The scientists want to make a test with companies, but it’s expensive right now. It costs hundreds of pounds, but they want to make it cheaper.
Dr. Sheona Scales, from Alzheimer’s Research UK, said, “This new study adds to the growing evidence that looking at certain proteins in healthy people’s blood could tell if they might get dementia before they have any symptoms.”
We need more studies to see if these tests work for everyone. Scales said, “Even if tests seem good in studies like this, they still need to get approved before doctors can use them.”
“Blood tests could help, but we need to make sure they’re okay to use in the UK. With Alzheimer’s Society, NIHR, and money from People’s Postcode Lottery, we’re giving money for research to make sure the NHS can use blood tests for Alzheimer’s.”
Prof Sir Stephen Powis, from the NHS, said they were getting ready for new treatments for Alzheimer’s when they’re safe. He said, “The pandemic made it hard to find people with dementia, but thanks to NHS staff, we’re finding more people with dementia than we have in three years.”
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