New Alzheimer’s Research Promises Cheap, Easy Test
Blood tests for those in the early stages of the disease could someday be as common as one for cholesterol.
Research into the early diagnosis of Alzheimer’s disease, which has frustrated medical researchers for years, is finally beginning to make some promising advances. A study earlier this summer in the Journal of the American Medical Association reported that researchers in Sweden have developed a blood test that correctly identified the disease in 90 percent of the patients who had reported memory problems.
The success of the test was particularly impressive when compared to existing techniques such as the use of PET imaging scans and invasive taps of spinal fluid, which predict the disease only 73 percent of the time. Both the imaging technology and the examination of cerebrospinal fluid require highly trained diagnostics and in the case of imaging is extremely expensive.
The research on the new blood test was presented in late July at the international science conference of the Alzheimer Association in Philadelphia. It is cheap and relatively simple to administer. The co-director of the Penn Memory Center at the University of Pennsylvania hailed the study as a major step forward in dramatically slashing the cost of diagnosis for Alzheimer’s. Dr. Jason Karlawish, who was not involved in the Swedish study, reportedly was impressed.
“Not too long ago measuring the pathology of the brain of a living human was considered just impossible,” Dr. Karlawish said. “This study adds to the revolution that has occurred in our ability to measure what’s going on in the brain of living humans.”
The day may not be far off, some experts suggested, when a test for Alzheimer’s may be as routine as a test for cholesterol.
Furthermore, the announcement of a small-scale pilot study at the University of Melbourne last week indicated that measuring potassium isotopes in blood serum showed the potential to diagnose the disease before cognitive decline or other disease symptoms became apparent.
At Emory’s Brain Health Center, Dr. Allan Levey, director of the Goizueta Alzheimer’s Disease Research Center, was optimistic about further breakthroughs in the diagnosis and treatment of the disease.
“It’s been a dramatic, dramatic revolution in healthcare,” Dr. Levey said, “to be able to all of a sudden increase the efficiency of diagnosis, increase the number of patients that can be seen with concerns about memory loss, create the specialized testing with the amyloid PET imaging samples, and then create the teams necessary to safely administer these new medicines.”
Also, earlier this summer, the FDA approved the third drug for the treatment of Alzheimer’s disease in its early stages. The federal agency in early July approved Kisunia, a drug developed by Eli Lilly. It’s administered through an expensive intravenous infusion therapy every four weeks but has been shown to be effective for patients with mild cognitive impairment.
The ability to diagnose the disease earlier, combined with drugs now and in the future that are effective early in the disease’s progression, according to Dr. Levey, would be an important advance for clinicians.
“We are needing to make a lot more progress on other causes of Alzheimer’s, but we can’t overlook this is a huge, huge advance to be able to identify people in the earlier stages more rapidly, efficiently, on a large scale that so we can get this into public health. These new medicines only work in the very early stages of the disease.”
The Swedish study used a blood test that measures a protein called ptau-217 that develops into tangles in the brain of those with Alzheimer’s. It has been found to be the most accurate way of predicting the development of the disease.
Approximately 1,200 patients with mild memory loss were used for the research.
For now, these tests are available only to doctors, not consumers. The test was briefly offered to consumers last year but Alzheimer’s experts became concerned that they should be restricted to a clinical setting until further treatments are available and doctors should decide who could get them.
Another important problem in this new era of research is how to bring in more primary care physicians to the treatment process. A severe shortage of trained neurologists, according to Dr. Levey at Emory, is one of the bottlenecks to overcome if treatment on a larger scale is to be accomplished.
“There’s nowhere near the number of specialists available to administer these new treatments that will come with easier testing. So, we’ve got to clearly address that gap. These are the strategies that we and others are taking to try to scale this so this can be done and managed more simply by primary care doctors, and then have the support of the specialists, rather than the specialist having to see every patient.”
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