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Genesis 18:32, 2 Chronicles 7:14, Acts 5:29
Blood Biomarkers to Detect Alzheimer Disease in Primary Care and Secondary Care
July 28, 2024Sebastian Palmqvist, MD, PhD1,2; Pontus Tideman, MSc1,2; Niklas Mattsson-Carlgren, MD, PhD1,3,4; et al Suzanne E. Schindler, MD, PhD5; Ruben Smith, MD, PhD1,2; Rik Ossenkoppele, PhD1,6,7; Susanna Calling, MD, PhD8,9; Tim West, PhD10; Mark Monane, MD, MBA10; Philip B. Verghese, PhD10; Joel B. Braunstein, MD, MBA10; Kaj Blennow, MD, PhD11,12,13; Shorena Janelidze, PhD1; Erik Stomrud, MD, PhD1,2; Gemma Salvadó, PhD1; Oskar Hansson, MD, PhD1,2
JAMA. Published online July 28, 2024. doi:10.1001/jama.2024.13855
Question Can a blood test based on the ratio of plasma phosphorylated tau 217 (p-tau217) relative to non–p-tau217 (expressed as percentage of p-tau217) combined with the amyloid-β 42 and amyloid-β 40 plasma ratio (the amyloid probability score 2 [APS2]) accurately identify Alzheimer disease in primary care and secondary care when prospectively applying predefined biomarker cutoff values?
Findings There were 1213 patients undergoing cognitive evaluation in primary or secondary care. The APS2 had high diagnostic accuracy (range, 88%-92%) for detecting Alzheimer disease pathology in both primary and secondary care. Dementia specialists identified clinical Alzheimer disease with a diagnostic accuracy of 73% vs 91% using the APS2 and primary care physicians had a diagnostic accuracy of 61% vs 91% using the APS2.
Meaning This blood test (the APS2) had high diagnostic accuracy for identifying Alzheimer disease among individuals with cognitive symptoms in primary and secondary care, providing superior performance compared with the diagnostic accuracy after standard clinical evaluation (not using Alzheimer disease biomarkers).
Abstract
Importance An accurate blood test for Alzheimer disease (AD) could streamline the diagnostic workup and treatment of AD.
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Blood Biomarkers to Detect Alzheimer Disease in Primary and Secondary Care
This prospective study evaluates a clinically available Alzheimer disease blood test in primary and secondary care using predefined biomarker cutoff values.
jamanetwork.com
EDITORIAL [concerning the above article]
Are Blood Tests for Alzheimer Disease Ready for Prime Time?
July 28, 2024Stephen Salloway, MD, MS1; Christopher Rowe, MD2,3,4; Jeffrey M. Burns, MD, MS5
JAMA. Published online July 28, 2024. doi:10.1001/jama.2024.12814
"These robust correlations have important implications for clinical practice. This study4 makes the case convincingly that highly sensitive blood measures of Alzheimer disease can be integrated into the clinical decision-making process, including in the primary care setting. These tests can be used to enhance the ability of clinicians to accurately identify individuals with cognitive impairment and dementia due to Alzheimer disease. Accurate and early diagnosis of Alzheimer disease is increasingly important because of the new era of monoclonal antibodies targeting amyloid reduction in the brain.5
Importantly, the study4 suggests that these tests are most useful for people with mild cognitive impairment and dementia. In those with subjective cognitive decline, the positive predictive value for identifying Alzheimer disease pathology was suboptimal. Current practice should focus on using these blood biomarkers in individuals with cognitive impairment rather than in those with normal cognition or subjective cognitive decline until further research demonstrates effective interventions for individuals considered cognitively normal with elevated levels of amyloid."
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Blood Tests for Alzheimer Disease
This is a transformative time for patients with Alzheimer disease. Alzheimer disease is increasingly viewed as a treatable condition and managed like other major chronic diseases, such as heart disease and cancer. Management of Alzheimer disease includes early diagnosis with molecular...
jamanetwork.com
Related article in the same journal:
Changes in Alzheimer Disease Blood Biomarkers and Associations With Incident All-Cause Dementia
July 28, 2024Yifei Lu, PhD1; James Russell Pike, MBA2,3; Jinyu Chen, MS4; et al Keenan A. Walker, PhD5; Kevin J. Sullivan, PhD6; Bharat Thyagarajan, MD, PhD7; Michelle M. Mielke, PhD8; Pamela L. Lutsey, PhD, MPH9; David Knopman, MD10; Rebecca F. Gottesman, MD, PhD11; A. Richey Sharrett, MD, DrPH4; Josef Coresh, MD, PhD3,12; Thomas H. Mosley, PhD6; Priya Palta, PhD, MHS13
JAMA. Published online July 28, 2024. doi:10.1001/jama.2024.6619
Alzheimer Disease Blood Biomarkers and Incident Dementia
This cohort study characterizes temporal changes in plasma biomarkers, identifies factors associated with changes in plasma biomarkers over time, and evaluates the prospective associations of plasma biomarkers with late-life all-cause dementia.
jamanetwork.com
GOD!!! \o/ \o/ in Jesus' Name \o/ \o/
