Wednesday, April 30, 2014

A blood test for Alzheimers disease?

Mapstone et al. have identified a set of 10 lipids whose levels predict, with an accuracy of over 90%, whether or not an older individual will develop mild cognitive impairment or Alzheimer's disease within 2–3 years. If this work is confirmed by other independent and more extensive studies, we may be seeing a clinical test within a few years. Would this 72 year old take such a test? Probably so, because avoiding the possible bad news would mean I might be less likely to get financial, legal, personal stuff in order (things like planing for care and informing family.)
Alzheimer's disease causes a progressive dementia that currently affects over 35 million individuals worldwide and is expected to affect 115 million by 2050. There are no cures or disease-modifying therapies, and this may be due to our inability to detect the disease before it has progressed to produce evident memory loss and functional decline. Biomarkers of preclinical disease will be critical to the development of disease-modifying or even preventative therapies. Unfortunately, current biomarkers for early disease, including cerebrospinal fluid tau and amyloid-β levels, structural and functional magnetic resonance imaging and the recent use of brain amyloid imaging or inflammaging, are limited because they are either invasive, time-consuming or expensive. Blood-based biomarkers may be a more attractive option, but none can currently detect preclinical Alzheimer's disease with the required sensitivity and specificity. Herein, we describe our lipidomic approach to detecting preclinical Alzheimer's disease in a group of cognitively normal older adults. We discovered and validated a set of ten lipids from peripheral blood that predicted phenoconversion to either amnestic mild cognitive impairment or Alzheimer's disease within a 2–3 year timeframe with over 90% accuracy. This biomarker panel, reflecting cell membrane integrity, may be sensitive to early neurodegeneration of preclinical Alzheimer's disease.

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