Blood biomarkers for Alzheimer's disease in clinical practice and trials.
Oskar HanssonKaj BlennowHenrik ZetterbergJeffrey L DagePublished in: Nature aging (2023)
Blood-based biomarkers hold great promise to revolutionize the diagnostic and prognostic work-up of Alzheimer's disease (AD) in clinical practice. This is very timely, considering the recent development of anti-amyloid-β (Aβ) immunotherapies. Several assays for measuring phosphorylated tau (p-tau) in plasma exhibit high diagnostic accuracy in distinguishing AD from all other neurodegenerative diseases in patients with cognitive impairment. Prognostic models based on plasma p-tau levels can also predict future development of AD dementia in patients with mild cognitive complaints. The use of such high-performing plasma p-tau assays in the clinical practice of specialist memory clinics would reduce the need for more costly investigations involving cerebrospinal fluid samples or positron emission tomography. Indeed, blood-based biomarkers already facilitate identification of individuals with pre-symptomatic AD in the context of clinical trials. Longitudinal measurements of such biomarkers will also improve the detection of relevant disease-modifying effects of new drugs or lifestyle interventions.
Keyphrases
- cerebrospinal fluid
- clinical practice
- positron emission tomography
- cognitive impairment
- clinical trial
- computed tomography
- cognitive decline
- physical activity
- primary care
- mild cognitive impairment
- high throughput
- metabolic syndrome
- palliative care
- working memory
- machine learning
- randomized controlled trial
- weight loss
- type diabetes
- study protocol
- pet ct
- current status
- phase ii