Early Blood Test To Predict Dementia Is Step Closer As Biological Markets Identified 39
Researchers have made significant progress toward developing a blood test that can predict the risk of dementia up to 15 years before clinical diagnosis. The Guardian reports: Hopes for the test were raised after scientists discovered biological markers for the condition in blood samples collected from more than 50,000 healthy volunteers enrolled in the UK Biobank project. Analysis of the blood identified patterns of four proteins that predicted the onset of dementia in general, and Alzheimer's disease and vascular dementia specifically, in older age. When combined with more conventional risk factors such as age, sex, education and genetic susceptibility, the protein profiles allowed researchers to predict dementia with an estimated 90% accuracy nearly 15 years before people received clinical confirmation of the disease.
For the latest study, blood samples from 52,645 UK adults without dementia were collected and frozen between 2006 and 2010 and analyzed 10 to 15 years later. More than 1,400 participants went on to develop dementia. Using artificial intelligence, the researchers looked for connections between nearly 1,500 blood proteins and developing dementia years later. Writing in Nature Aging, they describe how four proteins, Gfap, Nefl, Gdf15 and Ltbp2, were present in unusual levels among those who developed all-cause dementia, Alzheimer's disease or vascular dementia. Higher levels of the proteins were warning signs of disease. Inflammation in the brain can trigger cells called astrocytes to over-produce Gfap, a known biomarker for Alzheimer's. People with raised Gfap were more than twice as likely to develop dementia than those with lower levels.
Another blood protein, Nefl, is linked to nerve fibre damage, while higher than normal Gdf15 can occur after damage to the brain's blood vessels. Rising levels of Gfap and Ltbp2 was highly specific for dementia rather than other brain diseases, the scientists found, with changes occurring at least 10 years before people received a dementia diagnosis. The researchers are speaking to companies to develop the test but said the cost, currently at several hundred pounds, would need to come down to make it viable.
For the latest study, blood samples from 52,645 UK adults without dementia were collected and frozen between 2006 and 2010 and analyzed 10 to 15 years later. More than 1,400 participants went on to develop dementia. Using artificial intelligence, the researchers looked for connections between nearly 1,500 blood proteins and developing dementia years later. Writing in Nature Aging, they describe how four proteins, Gfap, Nefl, Gdf15 and Ltbp2, were present in unusual levels among those who developed all-cause dementia, Alzheimer's disease or vascular dementia. Higher levels of the proteins were warning signs of disease. Inflammation in the brain can trigger cells called astrocytes to over-produce Gfap, a known biomarker for Alzheimer's. People with raised Gfap were more than twice as likely to develop dementia than those with lower levels.
Another blood protein, Nefl, is linked to nerve fibre damage, while higher than normal Gdf15 can occur after damage to the brain's blood vessels. Rising levels of Gfap and Ltbp2 was highly specific for dementia rather than other brain diseases, the scientists found, with changes occurring at least 10 years before people received a dementia diagnosis. The researchers are speaking to companies to develop the test but said the cost, currently at several hundred pounds, would need to come down to make it viable.
In my unfortunate experience (Score:5, Insightful)
The biggest obstacle to detecting dementia is denial. Not just of the person with dementia, but everyone around them - nobody wants to admit it, they make excuses for the symptoms, etc.
Dementia gets diagnosed when it gets so bad that denial is no longer effective... when they wander, crash the car because they're frozen in confusion, etc.
I don't think a blood test - as wonderful as the option would be for those who would take it - will do much good for the average person who may be developing dementia.
Re:In my unfortunate experience (Score:4, Informative)
The biggest obstacle to detecting dementia is denial. Not just of the person with dementia, but everyone around them
This. My mother hid my father's dementia from all of us. It was a disservice to him and everyone else. Once we all started to notice she admitted it had been going on for several years and that she worked to keep us from finding out.
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Over a long enough timeline, surprise, all of our cognizant abilities diminish.
Fools. That's what makes the angels jealous. Being finite is hard. Being forever gives you too much time to think.
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This. My mother hid my father's dementia from all of us. It was a disservice to him and everyone else. Once we all started to notice she admitted it had been going on for several years and that she worked to keep us from finding out.
You ever even consider that she was doing as she thought best, by protecting his "honor" (for lack of a better and more precise term that I cannot come up with at the moment)?
I mean, how many decades did your mother spend with your father? I'll assume many.. 24 hours a day, seven days a week, 365 days a year...
I guarantee you, she knew him a hell of a lot better than you did, even assuming you had a super-awesome, triple-A, best-friend type relationship.
She's the only one on Earth, besides him, who c
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"She's the only one on Earth, besides him, who can decide if it was a disservice. You're not in the position to make that call"
You don't or can't know that. She's elderly too which means the likelihood of her suffering her own health catastrophe grows ever more likely & if that happens the family now has TWO sets of problems, one of which they could have been preparing for years.
I've seen both scenarios, the good thing is that the family with an otherwise healthy grandmother who began to slide into deme
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"She's the only one on Earth..."
Why? Because she is closest to him?
What do you know about their family dynamics?
And how close are YOU to their situation?
Sit down.
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I think you replied to the wrong post
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This. My mother hid my father's dementia from all of us. It was a disservice to him and everyone else. Once we all started to notice she admitted it had been going on for several years and that she worked to keep us from finding out.
You ever even consider that she was doing as she thought best, by protecting his "honor" (for lack of a better and more precise term that I cannot come up with at the moment)?
I mean, how many decades did your mother spend with your father? I'll assume many.. 24 hours a day, seven days a week, 365 days a year...
I guarantee you, she knew him a hell of a lot better than you did, even assuming you had a super-awesome, triple-A, best-friend type relationship.
She's the only one on Earth, besides him, who can decide if it was a disservice. You're not in the position to make that call. Fathers don't tell everything to their sons. Fathers do not confide everything to their sons. But good wives... they know their husbands.
You're so off base you landed on mars man.
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We had vice-versa experience, it was obvious he was losing it, but impossible to prove to attorney's, others, as he'd rise to the occasion and seem lucid in the moment.
A blood test would enable preparatory steps, different financial planning, care plans, insurance, plans, etc.
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>he was losing it, but impossible to prove to attorney's, others, as he'd rise to the occasion and seem lucid in the moment
That's when you learn about 'sundowning'. People with dementia don't have the mental reserves, so they can't stay awake and sharp as long as a healthy person.
Some demanding social interaction before and after lunch, and as late an appointment as you can manage, and odds are pretty good they'll be at their least acute when it is time for their assessment.
Lucid and rational in the moment can be normal (Score:2)
We had vice-versa experience, it was obvious he was losing it, but impossible to prove to attorney's, others, as he'd rise to the occasion and seem lucid in the moment.
They can be lucid and have rational conversation in the moment. Depending on the specific degenerative disease. They don't appear senile, yet their short term memories don't last more than a day or two. Only the long term memories that are already established persist. You can literally have conversations about their condition, show the evidence, get them to agree to modify their behaviors (ex stop driving themselves), they honest accept the evidence and agree its time to do so. And a few days later its all
Behaviors need to change while still mostly OK (Score:2)
The biggest obstacle to detecting dementia is denial. Not just of the person with dementia, but everyone around them - nobody wants to admit it, they make excuses for the symptoms, etc.
I'm not sure about that. I've seen families try to adapt as soon as problems arise, even before official diagnosis. The problem really is the afflicted person. Families try to get the person afflicted with some degenerative illness to change their behaviors at very early stage when they are still mostly OK. Suffering only minor impairent. The afflicted say they'll change when it gets worse. It doesn't work that way. If behaviors need to change, like not driving oneself, it has to happen when they are still
Re:In my unfortunate experience (Score:5, Informative)
It's not always conscious denial; the person may quickly become so far gone that they never noticed there was a problem.
Example: an elderly lady who close relatives and friends don't notice has any mental issues, has a trauma such as a fall. Needing rehab after the initial hospital stay, they check themselves into a ("temporary") rehab nursing facility. The next thing you know, although nobody has diagnosed a stroke or anything obvious, they are in rapid mental decline. About 3 or 4 months go by stuck in there, cut off from their lives, they have totally lost it.
I've seen it more than once, but at this moment I am watching it happen over a friend's shoulder. The family all having died (nobody had kids), the victim is nine months so far stuck in a 60-day rehab (which is of course making a fortune off of her, and likely was largely responsible for her condition). The victim had been a highly paid Dietician ("to the stars" type of clients) out there in L.A. and had retired just prior to this sad story. Now she can't raise her arms, cannot get out of the bed or stand, and is catheterized. She doesn't recognize people, and doesn't remember who is alive or dead. When she went in, she was mentally fine but needed rehab for walking after her fall. This is partly a story of elder abuse by the facility, but I'm just going to describe her mental state. My friend got an advocate and they are trying to rescue her.
The advocate met the victim last week and spent a couple hours at the bedside to do an evaluation. "How are you doing?" and "What year is it?" and friendly inquisitive conversation, probing her mental state.
She is relatively cheerful, but has no idea where she is or how she got there (she actually checked herself in), doesn't understand what's going on. So her brain has invented a story to account for some of the circumstances. She thinks she's in the facility because she is a consulting Dietician working on a contact there. She says she gets out of the bed, stands and walks, does her normal things and takes care of herself, drives her car, and everything. All of this is pure fantasy. She accounts for being in the bed that she was working, but just gets so tired for some reason and they are letting her take a nap in the room.
Total and complete la-la-land.
It's not exactly denial, except maybe self-denial at some subconscious level. Unlike many dementia patients, she's not upset or frustrated or scared. She's living in a complete fantasy world.
This all happened within the space of a few months. She may have had a stroke, since we notice she never uses her left arm. The facility is a shit-hole, never did any of the physical rehab, never has done any evaluation or her condition, and isn't taking care of her at all except in a minimal life-support fashion (feeding and catheterizing her). Atrophied and distorted limbs, bedsores, etc. It is only legal for her to be there for 60 days but they have kept her for nine months so far. They are billing over $10,000 a month. They are refusing access to the last living relative.
With that kind of cost, she could be in a VERY nice nursing home with proper physical and specialized dementia care. My friend is trying to rescue her to effect this as I write this.
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A note to readers with elderly: I feel guilty because we decided that I
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Markers, not Markets (Score:5, Informative)
Be wary of this kind of testing (Score:5, Informative)
In short, unless there's specific reason to believe that the test will actually result in better and more appropriate treatment (e.g. it indicates whether a specific treatment will or will not work), be wary of it.
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+1
I would like to add also the fact that if someone gets this diagnosis and somehow loses their freedom because of others acting in the diagnosed ones' 'best interest' even though the person can function normally.
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But if someone can get a prescription for Aricept it could slow the onset...
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I think you missed the point of my comment. Let me be more forward. People will be judgemental toward the 'diagnosed' although they can function. Possibly used as a form of control or banishment. You know, because love.
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3- If there aren't any treatments that alter the course of the disease, then the finding basically makes the patient needlessly worried and can frequently lead to unnecessary testing and treatment.
There might be, though.
It is well established that type 2 diabetes is a strong predictor for dementia, and that for people of a given age, the probability of dementia increases as the number of years that they've had diabetes increases. I've actually read a paper where researchers described Alzheimer's as diabetes of the brain.
Whether taking steps to head off diabetes (increased exercise, controlling diet, etc.) can reduce the risk of or the progression of dementia is unclear, of course.
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It could be useful in a trial setting as a screening tool for study population enrichment. A big problem with clinical trials investigating treatments for dementia (and in particular, Alzheimer's) is that either (1) the intent-to-treat population contains too many participants who don't have the disease; or (2) the patients who have the disease are at a stage of disease progression that reduces intervention efficacy.
We've conducted trials in the apolipoprotein-e4 population, for example, and more recently,
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Why am I not surprised? Thanks for sharing.
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Come ye, come ye and get your tests!! (Score:5, Funny)
Biological markets have been identified! Now you can get all of your biological needs half off! Operators are standing by!!
But seriously, does anyone proofread the titles? Should be: BIOLOGICAL MARKERS.
Markets? (Score:2, Funny)
I'm sure you'll find a strong market for the Elixer of Life, but that does not really bring it closer.
(Now that I've posted, I'll go RTFS.)
of course (Score:2)
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Well if this test actually works I would want everyone when they hit like 50 to get it annually, seems like a thing that has only upsides to detect early on.
But otherwise you are not wrong that Americans per capita do too much medical testing and don't really get many upsides but wasted money.
Americans waste $200 billion every year on medical tests they don’t need, experts say [latimes.com]
And it's not even that they forget but the more I read about it seems like the system to share information is so confounding it
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Big pharma: Just a Freudian slip.
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Well, give them a Freudian slap.
The (G)fap gene? (Score:2)
Oh God. I think I might have that one.
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Beware of self misdiagnoses. You could go blind.
Error in Article Description ??? (Score:2, Redundant)
The Perfect Title (Score:3)
Yes, it's a typo - "markets" instead of "markers". But I challenge that assumption. I think it's the perfect title, and least for the cynics out there. Seldom is a medicine brought to the mass market if there's no way to profit from it.
This is about marketing a non-specific test for $$ (Score:2)
I watched my aunt go through this... (Score:2)
It was horrifying to watch my Aunt Minnie go through dementia. No one had any clue she'd progressed into dementia because when you called to see how she was doing she'd chat just like old times, when you visited she was just as charming and friendly as ever, you simply had no clue. But very quickly she'd started forgetting basic things - like eating - but she was happy, and when you called to check up on her she'd be her normal old self so we had no clue.
Then one day she left the house and forgot where sh