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A pioneering study indicates that Alzheimer’s disease is more widespread among individuals over the age of 85 than previously thought.
The research also found that one in ten people aged 70 and over would meet the criteria for enabling medicines Slowing down the initial stage of the condition.
Using a simple blood test to identify biomarkers linked to dementiaThe study’s findings underline the critical importance of early detection.
Experts have described the disease as a “global challenge” and stressed that “it is vital that we are able to detect symptoms of dementia at the earliest possible stages.”
Researchers from King’s College London, Stavanger University Hospital and the University of Gothenburg analyzed 11,486 blood samples from participants over the age of 57 in Norway’s Trøndelag Health Study.
They specifically looked for the frequency of blood proteins associated with cognitive impairment – a gradual decline in thinking, memory and reasoning.
Their analysis revealed that the presence of Alzheimer’s disease neuropathological changes (ADNC)Protein deposits that cause nerve cell death increase with age.
According to the study, it was higher in older people but lower in younger groups than previously estimated.
ADNC was present in less than 8 percent of people aged 65–69, increasing to 65.2 percent in patients older than 90.
The study found that among people over 70, 10 percent had pre-clinical Alzheimer’s disease with no symptoms, while 9.8 percent had Alzheimer’s dementia.
Some 10.4 percent had prodromal Alzheimer’s, the stage between pre-clinical and dementia, when memory and thinking problems are noticeable due to cognitive impairment.
Researchers suggest that 11 percent of people aged over 70 would be eligible for antibody treatments that slow the early stages of the disease.
These drugs include donanemab and lecanumab, which are licensed for use in the UK but will not be made available on the NHS because the spending watchdog deemed their benefits “too small” to justify the cost.
Dag Aarsland, Professor of Geriatric Psychiatry at King’s IOPPN, said: “In an aging global population, the assessment and treatment of dementia presents a significant challenge.
“Our study used a simple blood test to establish the changes that contribute to cognitive impairment in people with dementia.
“In doing so, we found that approximately 11 percent of participants over the age of 70 met the eligibility criteria for monoclonal antibody treatments that could potentially slow the effects of cognitive decline in these individuals.
“If we are to meet this global challenge, it is vital that we are able to detect symptoms of dementia at the earliest possible stages. This blood test appears to be an effective means of providing clarity on a large scale.”
Elsewhere, researchers found that ADNC was “more prevalent among individuals with less education”.
Blood tests to diagnose Alzheimer’s disease are also not available on the NHS.
Currently, doctors use lumbar puncture or PET scan to test for ADNC.
However, a trial announced in September will recruit 1,100 people from memory clinics to find out how well the blood test works on healthcare, with results expected in three years.
Commenting on the findings, David Thomas, head of policy and public affairs at Alzheimer’s Research UK, said: “High-quality studies like this are important to increase our understanding of how blood tests for Alzheimer’s can be used in clinical practice.
“These tests have great potential to support early and accurate dementia diagnosis.
“They are less invasive, relatively cheaper, and more scalable than existing tests that detect biological signs of Alzheimer’s disease, such as PET scans and spinal fluid sampling.
“However, detection of proteins associated with Alzheimer’s disease is not a diagnosis in itself.
“Some people will develop these proteins but never experience symptoms of the disease. Therefore, it is important to interpret these findings with caution.
“Blood test results may also be less sensitive in older adults and future studies should address this by testing in a broader age group.
“We need to generate more evidence so we can use these tests across the NHS.
“Alzheimer’s Research UK, the Alzheimer’s Society and other partners are funding the read-out of blood tests and the ADAPT studies to develop these insights. Alzheimer’s Research UK is calling on the government to invest in NHS services that provide dementia diagnosis to pave the way for new innovations in clinical practice.”
Dr Richard Oakley, associate director of research and innovation at the Alzheimer’s Society, said: “This is the first time we have seen this type of data from such a large group of people, with more than 11,000 blood samples analysed.
“This is a stark reminder of the scale of dementia. We already know it is the UK’s biggest killer, but its impact may be even bigger than we think.
“Blood tests could change the way Alzheimer’s disease is diagnosed. They are faster, cheaper and may be easier for patients to access than scans or lumbar punctures. Ultimately, these tests could help many more people get diagnosed earlier.”