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Blood test for Alzheimer’s disease moves closer to becoming a reality

Alzheimer Blood Test
Dr. Jori Fleisher, a neurologist, examines Thomas Doyle, who hopes blood tests may someday replace the invasive diagnostic testing he endured to be diagnosed with Lewy body dementia.
(Teresa Crawford / Associated Press)

Scientists are closing in on a long-sought goal — a blood test to screen people for possible signs of Alzheimer’s disease and other forms of dementia.

At the Alzheimer’s Assn. International Conference on Monday, half a dozen research groups gave new results on various experimental tests, including one that seems 88% accurate at indicating Alzheimer’s risk.

Doctors are hoping for something to use during routine exams, where most dementia symptoms are evaluated, to gauge who needs more extensive testing. Current tools such as brain scans and spinal fluid tests are too expensive or impractical for regular checkups.

“We need something quicker and dirtier. It doesn’t have to be perfect” to be useful for screening, said Maria Carrillo, the Alzheimer’s Assn.'s chief science officer.

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Dr. Richard Hodes, director of the National Institute on Aging, called the new results “very promising” and said blood tests soon will be used to choose and monitor people for federally funded studies. It will take a little longer to establish their value in routine medical care, he said.

“In the past year we’ve seen a dramatic acceleration in progress” on these tests, Hodes said. “This has happened at a pace that is far faster than any of us would have expected.”

It can’t come too soon for patients like Tom Doyle, a 66-year-old former university professor from Chicago who has had two spinal fluid tests since developing memory problems four years ago. First, he was told he didn’t have Alzheimer’s, then that he did. He ultimately was diagnosed with different problems — Lewy body dementia with Parkinson’s disease.

“They probably could have diagnosed me years ago accurately if they had had a blood test,” said Doyle, who represents patients on the Alzheimer’s Assn.'s board.

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About 50 million people worldwide have dementia, and Alzheimer’s is the most common form. Current medicines can sometimes ease symptoms temporarily; there is no cure.

Dozens of hoped-for treatments have failed in clinical studies, perhaps because people were enrolled after too much brain damage had occurred, and because too many subjects had problems other than Alzheimer’s.

A blood test — rather than subjective estimates of thinking skills — could get the right people into studies sooner, doctors hope.

One of the blood tests being developed measures abnormal versions of the protein that forms the plaques in the brain that are the hallmark of Alzheimer’s. Japanese researchers published a study of it last year, and on Monday they gave results from validation testing on 201 people with Alzheimer’s, other types of dementia, mild impairment or no symptoms.

The blood test results closely matched those from the three types of brain scans and the mental assessment exam that are currently used to test for Alzheimer’s, said Dr. Akinori Nakamura of the National Center for Geriatrics and Gerontology in Obu, Japan. The blood test correctly identified 92% of people who had Alzheimer’s and correctly ruled out 85% who did not have it, for an overall accuracy of 88%.

Shimadzu Corp. has rights to the test and is working to commercialize it, Nakamura said.

Another experimental test looks at neurofilament light, or NEFL, a protein that serves as a marker of nerve damage. Abdul Hye of King’s College London presented results of a study comparing blood levels of it in 2,300 people with various neurological conditions — including Alzheimer’s, other dementias, Parkinson’s, depression, multiple sclerosis and Lou Gehrig’s disease — along with healthy people for comparison.

NEFL levels were significantly higher in eight conditions, while only 2% of healthy adults had a level high enough to raise concern. The test doesn’t reveal which disorder someone has, but it may help rule one out when symptoms may be psychological or due to other problems.

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Later at the conference, Dr. Randall Bateman of Washington University School of Medicine in St. Louis will give new results on a blood test he helped develop. Like the Japanese test, it measures the abnormal Alzheimer protein, and the new results will show how well the test reflects what brain scans show on nearly 500 people.

“Everyone’s finding the same thing,” said Bateman, whose work is supported by the U.S. government and the Alzheimer’s Assn. “The results are remarkably similar across countries, across techniques.”

Washington University has patented and licensed the test to C2N Diagnostics, a company Bateman co-founded. He estimates a screening test could be as close as three years away.

What good will that do without a cure?

An Associated Press-NORC Center for Public Affairs Research poll conducted last year found that most Americans would want to know if they carried a gene tied to a disease even if it was incurable.

“What people want most of all is a diagnosis” if they’re having symptoms, said Jonathan Schott of University College London. “What we don’t like is not knowing what’s going on.”

Marchione writes for the Associated Press.


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