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Blood test can detect Alzheimer’s up to 10 years in advance

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Researchers have developed a highly-accurate blood test that can detect Alzheimer’s disease up to 10 years before symptoms arise.

A team of researchers from Rowan-Virtua School of Osteopathic Medicine (SOM) and Durin Technologies, have announced the results of a newly-designed blood test that can detect the presence of Alzheimer’s disease-related pathology up to 10 years before symptoms arise with a nearly 97 per cent accuracy rate. 

Their findings appear online ahead of press in the Journal of Alzheimer’s Disease.

The study involved 328 blood samples with the goal of determining if a test that monitors a small number of a patient’s autoantibodies can detect Alzheimer’s disease (AD)-related pathology at pre-symptomatic, prodromal (i.e., mild cognitive impairment), and mild-moderate stages of the disease.

The research team showed that their test, using just eight autoantibody biomarkers, could accurately identify the presence of Alzheimer’s disease pathology across the disease’s progression, including among those originally determined to have no trace of the disease. 

“Alzheimer’s disease pathology begins a decade or more before the emergence of hallmark symptoms,” explained Dr Robert Nagele, the founder and chief scientific officer at Durin Technologies, and a professor of Geriatrics and Gerontology at Rowan-Virtua SOM.

“An accurate, non-invasive blood test for early detection and monitoring of AD could bend the curve of clinical outcomes through earlier participation in clinical trials and monitoring of AD progression of patients under treatment.”

The samples used in this research were from participants enrolled in clinical studies at the Alzheimer’s Disease Neuroimaging Initiative, the New Jersey Institute for Successful Aging and the Parkinson’s Study Group. Samples from 106 healthy, non-demented participants served as controls. 

For a number of reasons, the test has significant potential to impact effective treatments for Alzheimer’s disease. The test is minimally invasive and inexpensive, it can diagnose or predict clinical decline in asymptomatic individuals, and it can monitor a patient’s progress while under treatment, making it ideal for use in clinical trials and in frontline and community primary care settings, including those in rural and economically disadvantaged regions. 

Dr Cassandra DeMarshall, the study’s lead investigator and Durin’s director of research, said: “Our test correctly identified nearly 97 percent of participants who were diagnosed as cognitively normal at the time their samples were taken, but who progressed, within an average of 48 months, to either the mild cognitive impairment stage or more advanced Alzheimer’s disease.

“To our knowledge, this is the first blood test to accurately detect Alzheimer’s-related pathology several years before either clinical symptoms or more expensive and invasive tests can identify the disease.”

The researchers noted that the use of autoantibodies as blood-based biomarkers is particularly exciting because it enables development of a platform technology for early detection of multiple diseases. 

 

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Glasgow clinic launches Alzheimer’s detection test

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NeuroClin – formerly known as Glasgow Memory Clinic – has partnered with Advance Tests to launch Scotland’s first commercially available blood biomarker test for early Alzheimer’s detection.

Designed for people with mild cognitive impairment (MCI) – subtle problems with memory and thinking – the LucentAD Complete test helps determine whether these symptoms are likely due to Alzheimer’s.

Dementia affects more than 90,000 people in Scotland and nearly one million across the UK each year.

Early diagnosis is becoming increasingly important following the recent UK approval of new disease-modifying drugs lecanemab and donanemab.

“We know that changes in the brain linked to Alzheimer’s begin years before symptoms appear,” said Dr Jennifer Lynch, medical director at NeuroClin.

“This new blood biomarker test helps us detect potential Alzheimer’s earlier, giving people access to lifestyle advice, and access to new disease-modifying treatments or research opportunities.”

The launch marks the first time a clinically validated blood test for Alzheimer’s has been available in Scotland outside a research trial setting, following national NHS trials exploring single-marker biomarker tests.

This new version uses a multi-marker approach and is now commercially available.

Developed by Lucent Diagnostics, the test is already widely used across the US, supported by multiple peer-reviewed studies and now covered by the Medicare system.

At NeuroClin, the new blood biomarker test will form part of a staged diagnostic pathway beginning with memory testing, followed by the blood test, genetic testing and specialist support where appropriate.

Dr Simon Worrell, chief medical officer at Advance Tests, said: “Bringing this diagnostic test to Scotland for the first time is a major milestone – not just for Advance Tests, but for patients and clinicians across the country.

“We are witnessing a rare and important moment in health innovation, where breakthroughs in diagnostics are aligned with breakthroughs in treatment.

“With newly approved drugs now available, and growing evidence that early lifestyle changes can delay progression, early diagnosis has never been more valuable.”

Henry Simmons, chief executive at Alzheimer’s Scotland, added: “While we wish blood biomarker tests were routinely available on the NHS, this is not yet the case.

“We welcome NeuroClin taking the lead in offering this service in Scotland, as earlier diagnosis can help people and families get answers sooner, plan ahead and access the right support and emerging treatments.”

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Brain shape changes could offer early warning signs of dementia, study suggests

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Ageing alters the brain’s shape in measurable ways that could provide early warning signs of dementia, potentially years before symptoms appear, researchers say.

Analysis of more than 2,600 brain scans from adults aged 30 to 97 revealed significant alterations in brain geometry linked to declines in memory, reasoning and other cognitive functions.

The inferior and anterior parts of the brain expanded outward, while the superior and posterior regions contracted inward. These uneven shifts were most evident in older adults showing cognitive decline.

Researchers at the University of California, Irvine’s Centre for the Neurobiology of Learning and Memory found that people with more pronounced posterior compression performed worse in reasoning tests, suggesting these geometric markers directly relate to brain function.

“Most studies of brain ageing focus on how much tissue is lost in different regions,” said Niels Janssen, senior author and professor at Universidad de La Laguna in Spain and visiting faculty at the CNLM.

“What we found is that the overall shape of the brain shifts in systematic ways, and those shifts are closely tied to whether someone shows cognitive impairment.”

One important implication involves the entorhinal cortex – a small but vital memory hub in the medial temporal lobe.

The study suggests age-related reshaping may press this region against the hard base of the skull.

The entorhinal cortex is one of the first areas where tau, a toxic protein linked to Alzheimer’s disease, accumulates.

The findings raise the possibility that mechanical and gravitational forces may contribute to its vulnerability in Alzheimer’s – a potential disease mechanism not previously considered.

“This could help explain why the entorhinal cortex is ground zero of Alzheimer’s pathology,” said study co-author Michael Yassa, director of the CNLM and James L McGaugh endowed chair.

“If the ageing brain is gradually shifting in a way that squeezes this fragile region against a rigid boundary, it may create the perfect storm for damage to take root. U

“nderstanding that process gives us a whole new way to think about the mechanisms of Alzheimer’s disease and the possibility of early detection.”

The researchers say their geometric approach could eventually provide new markers for identifying dementia risk, potentially before symptoms emerge.

“This isn’t just about measuring brain shrinkage,” added Janssen.

“It’s about seeing how the brain’s architecture responds to ageing and how that architecture predicts who is more likely to struggle with memory and thinking.”

The patterns were replicated in two independent datasets, reinforcing the consistency of these shape changes as a hallmark of ageing.

“We’re just beginning to unlock how brain geometry shapes disease,” said Yassa.

“But this research shows that the answers may be hiding in plain sight – in the shape of the brain itself.”

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Simple test can predict risk of severe liver disease

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A new blood test can predict the risk of severe liver disease up to 10 years in advance, raising hopes for earlier detection of cirrhosis and liver cancer.

The model, called CORE, combines five factors: age, sex and levels of three common liver enzymes (AST, ALT and GGT), which are routinely measured during health checks.

Researchers in Sweden and Finland evaluated CORE using data from more than 480,000 people in Stockholm who had health checks between 1985 and 1996. Participants were then followed for up to 30 years.

During that period, 1.5 per cent developed severe liver disease, including cirrhosis (scarring of the liver), liver cancer or the need for a transplant.

“These are diseases that are growing increasingly common and that have a poor prognosis if detected late,” said Rickard Strandberg, affiliated researcher at Karolinska Institutet’s department of medicine in Huddinge, who developed the test with colleague Hannes Hagström.

“Our method can predict the risk of severe liver disease within 10 years and is based on three simple routine blood tests.”

The CORE model proved highly accurate, distinguishing between people who did and did not later develop disease in 88 per cent of cases. That result was an improvement on the currently recommended FIB-4 method.

A web-based calculator is already available for doctors and nurses at www.core-model.com.

“This is an important step towards being able to offer early screening for liver disease in primary care,” said principal investigator Hannes Hagström, adjunct professor at Karolinska Institutet’s department of medicine in Huddinge and senior consultant at Karolinska University Hospital.

“Drug treatment is now available, soon hopefully also in Sweden, for treating people at a high risk of developing liver diseases such as cirrhosis or liver cancer.”

Professor Hagström added: “Primary care hasn’t had the tools to detect the risk of severe liver disease in time.

“FIB-4 is not suited for the general population and is less effective at predicting the future risk of severe liver disease.”

The model was also tested on two other population groups in Finland and the UK, where it again showed high accuracy in predicting risk.

The researchers said further testing is needed in groups at especially high risk, such as people with type 2 diabetes or obesity. They also noted the importance of linking the model into medical record systems to support its use in clinics.

The study was a collaboration between Karolinska Institutet, Helsinki University Hospital, Helsinki University and the Finnish Institute for Health and Welfare. It was financed by the Swedish Research Council, Region Stockholm (CIMED) and the Swedish Cancer Society.

Hannes Hagström is engaged in several collaborations with the pharmaceutical industry regarding liver disease prognosis, but none that is relevant to this study.

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