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Is Investment In New Alzheimer’s Testing Methods Misguided?

Is Investment In New Alzheimer’s Testing Methods Misguided? Hello everyone, I hope you are well. In today’s post, I will be sharing a guest post from Patrick Holford, CEO of the charity Food For The Brain. Patrick will explore whether blood tests for Alzheimer’s are a ‘misguided waste of money’. There is a lot of talk about the search for new tests to find those most likely to get Alzheimer’s disease. But is this misdirected?

Is Investment In New Alzheimer’s Testing Methods Misguided?

The search for new tests for Alzheimer’s is misdirected and potentially wasteful. That’s the argument made by the Alzheimer’s Prevention Expert Group (APEG). They advocate leveraging existing, cost-effective tools to identify at-risk individuals and promote preventative measures.

Cognitive Function

Our cognitive abilities are typically divided into several categories and subcategories, each representing a different aspect of mental functioning. For example, the broad category of Memory includes short-term, long-term, declarative, non-declarative, episodic, semantic, and others, and Executive Function includes planning, decision-making, problem-solving and inhibition. These varied abilities contribute to our overall cognitive functioning and are essential for daily activities, learning, and environmental interaction.

Cognitive function declines steadily from age 18, making it possible to spot individuals dropping faster than average and encourage preventative actions. Cognitive Function Tests (CFT), such as those offered by the charity foodforthebrain.org, can identify declining cognitive function. Over the past decade, nearly half a million people have been tested using the CFT via foodforthebrain.org, allowing for early intervention through dietary and lifestyle changes.

Testing And Diagnosis

Alzheimer’s, which makes up two-thirds of dementia cases, involves the shrinking of some regions of the brain as neurons die off. Imaging can successfully diagnose Alzheimer’s and distinguish it from other forms of dementia. Magnetic Resonance Imaging (MRI) is commonly used to identify structural changes in the brain, particularly atrophy in the hippocampus, a region critical for memory. Positron Emission Tomography (PET) scans provide further insights by visualising brain metabolism and detecting amyloid plaques, a hallmark of Alzheimer’s.

However, APEG highlights that while these specialised brain scans can detect Alzheimer’s years before diagnosis, their high cost limits widespread use, plus these scans are not guaranteed to be performed early enough to discover those at risk’.

Biomarkers are another available tool for early diagnosis of Alzheimer’s disease. Cerebrospinal fluid (CSF) analysis can detect abnormal levels of beta-amyloid, total tau, and phosphorylated tau proteins, indicative of Alzheimer’s pathology. Although the toxic protein p-tau can be found in CSF, detection via lumbar puncture is risky, expensive, and unsuitable for testing tens of thousands of people.

Work towards developing a blood test that could identify those heading towards Alzheimer’s earlier is exciting many in this field; this type of test could be a cheaper and less invasive alternative to expensive scans. But APEG questions the pursuit of a blood test for Alzheimer’s, suggesting that it might be driven by pharmaceutical interests rather than patient benefit. They caution that such tests could lead to overdiagnosis and unnecessary treatment, similar to current practices with amyloid-targeting drugs, which have not shown significant clinical benefits and carry severe risks.

Leveraging Existing Knowledge

APEG advocates a more pragmatic approach: using cost-effective, accessible tests to identify modifiable risk factors. For instance, homocysteine, a toxic amino acid, rises with age and insufficient intake of B vitamins (B6, folate, B12). Elevated homocysteine levels increase p-tau accumulation, but addressing vitamin deficiencies can reduce this risk. The VITACOG trial, run by pharmacology professor David Smith (a member of APEG), demonstrated that high doses of B vitamins could slow brain cell death and arrest cognitive decline in individuals with Mild Cognitive Impairment (MCI) and high homocysteine levels.

Smith and his APEG colleagues favour using a Cognitive Function Test (which is free) to identify those at risk, followed by testing risk factors and biomarkers such as homocysteine to be included in the research funds being made available for testing blood biomarkers because this is one thing you can do something about.

Other valuable tests for risk factors include omega-3 and vitamin D levels since low levels of these nutrients also increase risk; and HbA1c, the standard measure used to diagnose diabetes, since lower levels help protect the brain and high levels indicate those who need to reduce their intake of sugar and processed foods.

These tests are corroborative rather than diagnostic, but they also identify prevention actions people can take. This two-step paradigm of testing cognitive function early and then having further blood tests, such as homocysteine, omega-3, vitamin D and HBA1c for glucose control, helps guide diet and lifestyle prevention strategies. And they are available right now.

The charity foodforthebrain.org offers a free cognitive function test, plus a home test kit that measures all these risk factors with a pinprick blood test.

Conclusion

Much work is going into Alzheimer’s diagnosis, with a range of current tests and new technologies promising in the future, from cognitive assessments and imaging to advanced biomarkers and digital tools. Early and accurate diagnosis, combined with actionable prevention measures, can significantly impact the management and progression of Alzheimer’s disease. As research continues, a balanced approach that integrates new technologies with practical prevention strategies will be crucial for improving outcomes for individuals at risk of Alzheimer’s.

I hope you enjoyed that.

Talk soon

ABOUT THE AUTHOR

Patrick Holford is the founder of foodforthebrain.org, a not-for-profit independent registered charity, and Chair of the Alzheimer’s Expert Group. https://foodforthebrain.org and https://foodforthebrain.org/apeg

EVIDENCE/REFERENCES:

The VITACOG trials, evidence for homocysteine as causal and lowering it with B vitamins as disease-modifying and a consensus statement regarding this evidence in the Journal of Alzheimer’s Disease is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836397/

The validation of foodforthebrain.org’s Cognitive Function Test in the International Journal of Geriatric Psychiatry is here: https://onlinelibrary.wiley.com/doi/abs/10.1002/gps.3993.

The evidence in relation to p-tau and homocysteine is here: https://foodforthebrain.org/the-p-tau-delusion/

Working with Strong women, I help empower women not to give up on their goals and find true happiness within themselves. #lifestyle #womenempowerment #selfcare

12 Comments

  • Melanie E

    New testing methods that are easy to administer and provide results quickly would be a good use of funds. The sooner it can be identified and a treatment plan set up the better.

  • Ramil Hinolan

    Using simple, cost-effective tests to find out who might get Alzheimer’s and help them early is a smart initiative. My family and I are always looking for ways to stay healthy, so I appreciate these tips.

  • Olga

    Alzheimer is one of my biggest fears. My aunt and grandmother had this disease and died to understand who they were. Thank you for an interesting article!

  • Richard Lowe

    Yes, testing for Alzheimer’s is essential, but, I would add, it’s not all that useful unless this also comes with a way to handle it. I would hate to know I had this condition but couldn’t do anything about it.

  • LisaLisa

    This is such a great post with so much information about Alzheimer’s diagnosis. I’m so glad to see so many tests are available for Alzheimer’s diagnosis, it’s such a dreadful disease.

  • Emily

    I think investing in Alzheimer’s research is incredibly important. It’s a disease that, hopefully, can be cured (or at least prevented) within our lifetime.

  • Kimberley Asante

    Insightful article on Alzheimer’s testing methods! It raises important questions about investment and efficacy. Thanks for sharing these thought-provoking points!

  • Stephanie

    Interesting read – some of what you point out is quite distressing while other info is promising. It is so sad to see people decline due to Alzheimer’s. Good to see various approaches being pursued.

  • Beth

    I love that today’s research goes further than just treatments. I think understanding the best way to test is an excellent rout to the best outcomes as well.

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