Blood test that can detect Alzheimer's at least four years B
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A blood test to detect two molecules that act as indicators of a person's likelihood to get Alzheimer's disease later in life could be a 'game-changer', a new study claims.

The two molecules – P-tau181, a tau protein, and neurofilament light polypeptide (NfL) – are found in plasma, the light yellow liquid that makes up 55 per cent of our blood.

In a sample of 573 people in their 60s and 70s, the presence of high levels of either P-tau181 and NfL were the most accurate predictors of the patient's progression from mild cognitive impairment (MCI) to severe memory and thinking problems, typical of Alzheimer's.

Researchers say blood tests to detect levels of the two molecules could allow doctors to track the progression of Alzheimer's disease in at-risk populations.

Although the exact cause of Alzheimer's disease is not yet fully understood, it is thought to be caused by the abnormal build-up of proteins in and around brain cells. One of the proteins involved is called amyloid, deposits of which form plaques around brain cells.

The other protein is called tau, deposits of which form tangles within brain cells. Although it's not known exactly what causes this process to begin, scientists now know that it begins many years before symptoms appear.

Researchers developed and validated models that could predict an individual's risk of cognitive decline and subsequent transition to Alzheimer's disease. They used data from 573 patients with minor cognitive impairments from two independent cohorts.

Researchers compared the accuracy of several models based on various combinations of blood biomarkers to predict cognitive decline and dementia over four years.

A decline in brain function was determined by the Mini–Mental State Examination (MMSE) – a 30-point test that consists of a series of questions and tests a number of different mental abilities, including a person's memory, attention and language.

They found the top predictors to be P-tau181, a type of tau protein already known to be a hallmark of Alzheimer's disease, and NfL known to be a marker of neuro-axonal damage.

Combined, they were almost 90 per cent accurate in identifying those who went on to develop the disease. The findings demonstrate the value of using specific combinations of blood-based biomarkers to make predictions for specific individuals with MCI.

'We know that over 50 per cent of people with MCI will go on to develop dementia, and it is important that we try to identify those who will and those who will not progress to be able to offer appropriate treatment and advice.'

'This study only looked at a few hundred people, but if these blood biomarkers can predict Alzheimer's in larger, more diverse groups, we could see a revolution in how we test new dementia drugs,' said researcher.

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