New model predicts cognitive decline in mild cognitive impairment from Alzheimer's.

Alzheimer's disease is a progressive neurodegenerative disorder that affects millions of individuals worldwide, leading to cognitive decline and ultimately, dementia. Mild Cognitive Impairment (MCI) is often considered a precursor to Alzheimer's disease, as individuals with MCI have an increased risk of developing dementia. A new model has been developed that predicts cognitive decline in individuals with MCI, providing valuable insights into the progression of Alzheimer's disease.

The new model utilizes data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) to predict cognitive decline in individuals with MCI over a two-year period. By analyzing various biomarkers such as brain imaging data, cerebrospinal fluid levels, and genetic markers, the model can accurately predict the rate of cognitive decline in individuals with MCI. This information is crucial for early intervention and treatment strategies for Alzheimer's disease.

The study involved testing blood for a key biomarker of Alzheimer’s called p-tau217, which increases at the same time as other damaging proteins — beta amyloid and tau — build up in the brains of people with the disease. Currently, to identify the buildup of beta amyloid and tau in the brain, patients undergo a brain scan or spinal tap, which often can be inaccessible and costly.

Research has shown that SCD can be an early indicator of future memory problems or AD, but most of this research has been done with people who seek medical help and may have higher risks of developing AD.

Community-based studies, which examine people who do not seek medical help, offer a more accurate picture of how SCD affects the general population. However, these studies often have limitations, such as small sample sizes, only one-time assessments, and less thorough testing.

When the researchers compared the blood test results with the PET images, they found that one biomarker, called plasma phosphorylated tau 217 (p-tau217), was most strongly associated with the presence of amyloid-beta. In addition, higher blood levels of p-tau217 correlated with greater amounts of brain cell–damaging tau protein.

Although the results need verification, the findings are a potentially exciting advance in the fight against Alzheimer's. A simple blood test may eventually help identify which people should go on to have expensive PET imaging or an invasive spinal tap, required to determine whether a person might benefit from anti-amyloid drugs or other future therapies. The results were published in the March 2024 issue of JAMA Neurology.

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Sarah H

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