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Medicine

A Blood Test Accurately Diagnosed Alzheimer's 90% of the Time, Study Finds 57

Posted by BeauHD from the cautiously-optimistic dept.
Scientists have developed a blood test that accurately identifies Alzheimer's disease in patients with memory issues 90% of the time (source may be paywalled; alternative source), significantly outperforming standard diagnostic methods. The findings have been published in the journal JAMA. The New York Times reports: The new study used a blood test that focuses on a form of a protein called tau that sprouts into tangles in the brains of people with Alzheimer's. Measuring that form, called ptau-217, was found to give the most accurate assessment of Alzheimer's pathology in a comparison of various Alzheimer's blood tests that will also be presented at the Alzheimer's Association conference. Tau is more closely linked to cognitive decline than amyloid, and tau tangles form later than amyloid plaques in Alzheimer's patients. The test in the study also tracks amyloid. Tests like this are available in the United States for use by doctors, not consumers.

The study included about 1,200 patients with mild memory problems. About 500 of them visited primary care physicians; the rest sought specialist care at memory clinics. Dr. Sebastian Palmqvist, an associate professor of neurology at Lund University who led the study with [Dr. Oskar Hansson, a professor of clinical memory research at Lund University in Sweden and the senior author of the study], said that first, about 300 patients in each group were given the blood test, and results were compared with spinal taps or PET scans. Then the researchers wanted to see how the blood test compared with the judgment of doctors after they administered cognitive tests and CT scans. "We started asking both the primary care physicians and our own dementia specialists: After the standard evaluation, do you think your patient has Alzheimer's disease?" Dr. Palmqvist said.

In evaluations of about 200 patients, primary care doctors who thought patients had Alzheimer's were wrong 36 percent of the time. And when they thought patients did not have Alzheimer's, they were wrong 41 percent of the time. Memory specialists who evaluated about 400 patients did somewhat better -- they were wrong 25 percent of the time when they thought patients had Alzheimer's and wrong 29 percent of the time when they thought patients didn't. The blood test was wrong only about 10 percent of the time. The blood test's accuracy was highest with patients who had already progressed to dementia and was slightly lower with patients in a pre-dementia stage called mild cognitive impairment, Dr. Palmqvist said. It was not very accurate with the earliest stage, called subjective cognitive decline, when patients begin to perceive their memory to be failing. Dr. Hansson said that lower accuracy probably occurred because many people with subjective cognitive decline do not turn out to have Alzheimer's.
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A Blood Test Accurately Diagnosed Alzheimer's 90% of the Time, Study Finds More

A Blood Test Accurately Diagnosed Alzheimer's 90% of the Time, Study Finds

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  • Not the best way (Score:4, Funny)

    by backslashdot ( 95548 ) on Wednesday July 31, 2024 @03:14AM (#64668858)

    Best way to diagnose it is if the patient can't remember they illegally sold weapons to Iran in order to fund militias in Central America.

    • Re:Not the best way (Score:4, Funny)

      by Firethorn ( 177587 ) on Wednesday July 31, 2024 @03:22AM (#64668868) Homepage Journal

      Dammit, I'm positive for that! I don't ever remember selling weapons to Iran, illegally or not, much less funding militias in Central America.

      So what's the treatment?

      • Congratulations, you get to retire on the taxpayer dime and the Republican party will build you a library.

        • Re:Not the best way (Score:4, Insightful)

          by iAmWaySmarterThanYou ( 10095012 ) on Wednesday July 31, 2024 @04:47AM (#64668958)

          The party doesn't build the library. Private donations do.

          Weird how you had to reach back to the 80s when Joe is right there.

  • Such a brutal disease (Score:5, Insightful)

    by shilly ( 142940 ) on Wednesday July 31, 2024 @03:57AM (#64668902)

    My friend is one of the UK’s most senior neurologists focused on dementia in the UK, and my mother-in-law has Alzheimer’s. He told us a few home truths at the start:
    - There’s no effective treatment, and none on the horizon. The drugs that are around have effects that can be seen at a population, but are not functionally apparent to a patient or family (about two points on the MMSE) and anyway they simply delay deterioration in a single symptom, forgetfulness, by about six months. In the course of a disease lasting a decade or so, that’s nothing to speak of; if you get the disease at 75, then by 80, you’ll have the memory loss you’d otherwise have had at 79.5
    - There’s nothing meaningful you can do by way of prevention. Diet, exercise, doing brain teasers - they all have no noticeable effect on your chances of getting Alzheimer’s. This is also true for the progression, which it what it is, and is not modifiable at all
    The apathy is worse than the memory loss. I remember asking “should we encourage her to come out with us on trips to the theatre etc?” And he shrugged and said “if it will give you pleasure, sure, but not for her. Her reward centres in her brain will dull over time, and so it has no benefits for her”
    - Patients know what’s coming in the early stages. It’s a horror show from which they know they won’t escape
    There’s exciting science being done that may change some of this one day, but for now, the only tools available are basic human stuff: kindness, compassion, good care (which is ferociously expensive), patience and empathy. Give me a heart attack any day.

    • Re:Such a brutal disease (Score:4, Informative)

      by Firethorn ( 177587 ) on Wednesday July 31, 2024 @04:08AM (#64668920) Homepage Journal

      There’s exciting science being done that may change some of this one day,

      This reminded me of the retracted studies that have been coming out, where it turned out that they were faked.

      How much damage has this done to discovering an effective treatment?

      • They were peer reviewed studies and then referenced by others for years. Until suddenly retracted after a fight.

        • Re: (Score:2, Interesting)

          by Firethorn ( 177587 )

          Well yes, but that doesn't answer my question:

          How much damage do you think the retracted studies did to the progress of Alzheimer's research and the development of medicine to treat it, given that it appears that the retracted studies sent the drug development companies down the wrong rabbit hole?

      • Re: (Score:2)

        by gweihir ( 88907 )

        There’s exciting science being done that may change some of this one day,

        This reminded me of the retracted studies that have been coming out, where it turned out that they were faked.

        How much damage has this done to discovering an effective treatment?

        A lot. I think scientific fraud should be treated as a capital crime with prison time. Its effects are often way too dramatic for a simple paper retraction.

      • This reminded me of the retracted studies that have been coming out, where it turned out that they were faked.

        Hang to those bastards! Their lies distracted research away from legitimate leads. My father had Alzheimer's, so I take these kinds of fraud personally.

    • Re: (Score:3)

      by chefren ( 17219 )

      There are in fact some new medicines coming into the market which have been shown to genuinely slow the progress of the disease, not just slow the effect it has on the memory. The catch is that you have to manage to be diagnosed with the disease before the typical symptoms set in, so they are not very useful yet.

      However this does mean that there is currently progress being made above and beyond the stagnancy of the last 25 years or so.

      • Re: (Score:3)

        by shilly ( 142940 )

        I wish it were so, but I’m sorry to say it’s not. The slowing of progression is sub-functional, ie an individual will not notice any benefit, although the effect can be seen in large enough populations. I agree, though, that the underlying science is now moving at a good pace cf the previous 25 years, and I’m hopeful that we’ll see some treatments that are truly useful appear in the next decade or two

        • I wish it were so, but I’m sorry to say it’s not. The slowing of progression is sub-functional, ie an individual will not notice any benefit, although the effect can be seen in large enough populations. I agree, though, that the underlying science is now moving at a good pace cf the previous 25 years, and I’m hopeful that we’ll see some treatments that are truly useful appear in the next decade or two

          That's the way I read it. Having a group that averages out to living longer doesn't mean much on the individual's scale.

          And even if the progression is slowed, all that means is longer in each stage, especially the last one, when the patient might be on Haldol or perhaps an atypical antipsychotic like Rexulti.

          I'm probably in a minority, but if I'm going to spend my last days rotting, I want that to get over the inevitable as quickly as possible, not extend things.

          • Re:Such a brutal disease (Score:5, Insightful)

            by shilly ( 142940 ) on Wednesday July 31, 2024 @01:42PM (#64670134)

            Practically everyone who spends any time with people with terminal prognoses will say that quality of life is much more important than the number of days. The phrase I learned many years ago was “compression of morbidity”. The NHS had quite a sophisticated approach to this a few years ago, summed up in the slogan “adding years to life, and life to years” - no-one wants to die early, and no-one wants to die badly.

            This reminds me of a beautiful story from Rabbi Abraham Twerski about his father’s terminal illness: “Father was extremely well-versed medicallyWhen the doctor suggested chemotherapy, Father said, "You know as well as I do that chemotherapy for cancer of the pancreas is not effective. All it can do is produce undesirable side-effects. If it could prolong life, then I would probably be required by Halacha [Jewish law] to do everything humanly possible to live longer, even if it meant living with distress. However, there is certainly no requirement to subject one's self to a treatment which will cause a great deal of misery and not prolong life." The doctor had to agree that Father was right.
            In his conversation with Mother, however, the doctor indicated that chemotherapy might prolong life by perhaps three months. Mother was adamant. As long as there was anything that could be done, it must be done. Who knows but that during those three months, the long awaited breakthrough in a cancer cure might come about.
            "Foolishness," said Father. But Mother would not yield.
            One time Father and I were alone, and he said, "You know, to subject myself to the misery of chemotherapy when there is nothing to be gained is ridiculous. But if it is not done, Mother will not be at ease. During our marriage I have done many things for Mother's happiness; and if I have the opportunity to do one last thing for her, I will not turn it down." “

      • There are in fact some new medicines coming into the market which have been shown to genuinely slow the progress of the disease, not just slow the effect it has on the memory. The catch is that you have to manage to be diagnosed with the disease before the typical symptoms set in, so they are not very useful yet.

        However this does mean that there is currently progress being made above and beyond the stagnancy of the last 25 years or so.

        Even if they work - the end result is the same - You just stretched out the long goodbye. Each stage might just take longer. My MIL was on some of those drugs. Her end was the same as all the others. Maybe some months longer.

    • Re: (Score:3)

      by Samare ( 2779329 )

      Intensive lifestyle changes seem to help a lot or even revert dementia: https://alzres.biomedcentral.c... [biomedcentral.com]
      Granted, that's not as easy as taking a pill. That's why there's no many people with cardiovascular diseases or diabetes.

      • Yeeesh! That study was a *throw everything and the kitchen sink at the problem* lifestyle change. That is a very intense change for any age group let alone 70 year olds.

        • Re: (Score:2)

          by Samare ( 2779329 )

          Now that we know something probably works, we can fine-tune the best way to prevent that disease.

      • Re: (Score:2)

        by shilly ( 142940 )

        Maybe, but we need n to be a lot bigger than 51 before we can truly conclude this

    • Re: (Score:2)

      by haruchai ( 17472 )

      In the past century, no male on my father's side has ever gone bald, developed cancer, dementia....or survived a heart attack.
      I still have all my hair; guess I know how I going out, if it's by natural causes. I'll take that over most of the other alternatives

    • > Thereâ(TM)s nothing meaningful you can do by way of prevention. Diet, exercise

      Not so if you treat it as a metabolic disease.

      ```
      The perspective of the use of [ketogenic diet] (KD) in various diseases has been growing recently. Abnormal glucose metabolism uptake, diminished mitochondrial-associated brain energy metabolism, changes in neurotransmitter release, and increased inflammatory response are the key pathophysiological metabolic alterations observed in AD. Furthermore, KD may modulate a broad

      • Re: (Score:3)

        by shilly ( 142940 )

        There are literally hundreds of studies purporting to show causal links between AD and various precursors and treatments. I am nowhere near qualified to be able to tell the actually promising from the plausible quackery. However, I'm lucky enough to have a friend who's an internationally renowned expert in the field who I've known for thirty years, and I'll rely on his word that there are no meaningful preventative measures rather than yours that there are. He's literally in charge of setting policy directi

    • The apathy is worse than the memory loss. I remember asking “should we encourage her to come out with us on trips to the theatre etc?” And he shrugged and said “if it will give you pleasure, sure, but not for her. Her reward centres in her brain will dull over time, and so it has no benefits for her”

      This one hurts the most for my family. I noticed issues in 2019 when I talked to my dad on the phone in the evening. Conversations weren't flowing logically, rambling was bad and I could see his house declining. We lived 7 hours away but tried to visit twice a year. He was starting to show no interest in his grand-daughter when we visited. When he was sent to memory care a couple years ago, the person I knew was just gone.

      Memory Care is stupid expensive. He burned through $110K+ in a year just to have

  • Remember mad cow disease, similar symptoms and takes many years after eating infected meat products to develop symptoms https://en.wikipedia.org/wiki/... [wikipedia.org]â"Jakob_disease?wprov=sfla1

  • When Practicing pushes the limits. (Score:5, Insightful)

    by geekmux ( 1040042 ) on Wednesday July 31, 2024 @06:04AM (#64669026)

    In evaluations of about 200 patients, primary care doctors who thought patients had Alzheimer's were wrong 36 percent of the time. And when they thought patients did not have Alzheimer's, they were wrong 41 percent of the time.

    Giving someone a wrong diagnosis is bad enough, but when you hand someone a rather terminal diagnosis that is wrong, you can end up causing considerably more harm. Depression, stress, and even suicide all come into play for the falsely-diagnosed patient, who has now become a victim.

    Many people can’t afford the first medical opinion. Let alone a second one to validate. And with a 40%+ failure rate, there’s a chance doctors could screw up again with the wrong diagnosis. We love and appreciate our doctors, but NO profession should accept a 40%+ failure rate and dismiss it under the guise of “practicing”. Do doctors really expect or assume society will respect the title of Doctor and pay that highly trained professional a premium, providing accuracy like that?

    Three cheers for a 90% accuracy test, but sounds like we should have been double and triple checking tests and initial diagnosis to fix an unacceptable accuracy level made worse by not instituting a double/triple check policy across that specific profession LONG ago.

    • Alzheimer's is not terminal cancer. People aren't running out and hanging themselves over a diagnosis that says they will suffer cognitive decline in a time period that would see out two sitting presidents.

      We love and appreciate our doctors, but NO profession should accept a 40%+ failure rate and dismiss it under the guise of “practicing”. Do doctors really expect or assume society will respect the title of Doctor and pay that highly trained professional a premium, providing accuracy like that?

      Society does despite your fearmongering. The fact you want to throw an entire profession under the bus due to a single difficult to diagnose disease speaks far more about you than it does about doctors.

      • Alzheimer's is not terminal cancer. People aren't running out and hanging themselves over a diagnosis that says they will suffer cognitive decline in a time period that would see out two sitting presidents.

        But it is terminal nonetheless. If I'm diagnosed, I won't hang myself, but I will definitely take myself out some way.

        Having a bit of experience with Alzheimer's patients, the idea of rotting away over the course of 10 years or so is pretty horrifying. You are often drugged with an antipsychotic, especially if you are a screamer or constant cryer. It's a nasty and un-dignified existence.

        And in the later stages, there is really no "you" any more. It's called the "long goodbye" for a reason. Better get

        • That's a bleak way to look at it. You might as well take yourself out right now because you could possibly get hit by a car and become paralyzed tomorrow, and have to live an undignified life for an unknown amount of time (because you can't move to take yourself out then) before you die of related complications.

          If I'm diagnosed I'll stick around because there's a 36% chance I don't actually have it, there's a tiny chance someone will discover a treatment/cure (or heck maybe some way to upload my remaining

          • That's a bleak way to look at it. You might as well take yourself out right now because you could possibly get hit by a car and become paralyzed tomorrow, and have to live an undignified life for an unknown amount of time (because you can't move to take yourself out then) before you die of related complications. Ah - well if you think that's the case - that is on you. I'm not bleak or unhappy at all. If something like what you are talking about happens - well that's just the luck of the draw. Perhaps you are against advance directives too? If I'm in a PVS, My directive is to withold treatment.

            I get it - there are people who will fight to the bitter end - even if is not them they are fighting for. Then again, some people still think Terri Schaivo was murdered even after her biopsy showed the only thing left of her brain was the stem after her husband finally won the battle to take her off the machines. The Republican party was prepared to evacuate her from the nursing home if Katrina came through - while allowing healthy people to die in N'awlins.

            If I'm diagnosed I'll stick around because there's a 36% chance I don't actually have it, there's a tiny chance someone will discover a treatment/cure

            Are you prepared to have the nursing home, take your estate while you rot? Are you accepting of having your family watch you rot? I've been through that twice now, and I have to tell you that watching them rot was 100 times worse then say, my mother, who died of a massive heart attack and was gone immediately.

            The alternative is like the SO's friends brother who hung on bedridden and under large doses of drugs. He hung onto life for months after he was supposed to have died. They got to the point of wishi

            • Are you prepared to have the nursing home, take your estate while you rot? Are you accepting of having your family watch you rot?

              I don't view it as rotting any more/less than living without Alzheimer's is rotting, but sure. I think having my family dependent on my estate would be foolish because anything could happen. If I get hit by a car and become paralyzed tomorrow, my care would probably cost more than if I got Alzheimer's because I could live much longer. If I get hit by a car and killed tomorrow my

      • Alzheimer's is not terminal cancer. People aren't running out and hanging themselves over a diagnosis that says they will suffer cognitive decline in a time period that would see out two sitting presidents.

        Thats quite an ignorant assumption to make. Any disease attacking the organ that defines one’s self, their capabilities that define a profession or career, and the memories they hold dear, is a considerable one. We’ve unfortunately heard of people taking their own lives for this disease and a hell of a lot less. Humans can and often DO react badly to bad news regardless of what you assume.

        We love and appreciate our doctors, but NO profession should accept a 40%+ failure rate and dismiss it under the guise of “practicing”. Do doctors really expect or assume society will respect the title of Doctor and pay that highly trained professional a premium, providing accuracy like that?

        Society does despite your fearmongering. The fact you want to throw an entire profession under the bus due to a single difficult to diagnose disease speaks far more about you than it does about doctors.

        I didn’t attack the profession. I’m attacking those who failed to see an unacceptable diagnos

  • ...if you've already read TFS but can't remember, book an appointment with your physician.

  • Sure (Score:2)

    by PPH ( 736903 )

    Just have the nurse come in and jab you for a sample every few hours. If you forget that you already got stuck, you're positive.

  • That way one can commit suicide before one is too far gone to do it.

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