Latest news with #AlzheimersAssociation
Medscape
19 hours ago
- Health
- Medscape
First Guideline on AD Blood-Based Biomarker Tests Released
TORONTO — An expert panel convened by the Alzheimer's Association has released the first clinical guidelines to help clinicians choose the most appropriate blood-based biomarker (BBM) test to aid in the diagnosis of Alzheimer's disease (AD). The evidence-based guideline recommends that tests with ≥ 90% sensitivity and specificity can serve as a substitute for amyloid PET or cerebrospinal fluid (CSF) biomarker testing. Tests with ≥ 90% sensitivity but only ≥ 75% specificity should be used as a triaging test. In this case, a negative result rules out AD pathology with high probability and a positive result should be confirmed with CSF or PET testing. Evidence-based guidelines are key to standardizing the use of BBMs in clinical practice, Rebecca M. Edelmayer, PhD, vice president of scientific engagement for the Alzheimer's Association, told Medscape Medical News. 'The whole purpose of developing the clinical practice guideline is to try to create pragmatic recommendations for clinicians on how to choose the right test for the right patient at the right time,' Edelmayer said. This new guideline is the first step in a developing process, she added. 'The blood-based biomarker area is still a burgeoning field.' The findings were presented on July 29 at the Alzheimer's Association International Conference (AAIC) 2025 and published online simultaneously in Alzheimer's & Dementia . Meeting a Need With the approval of anti-amyloid beta (Aβ) therapies to treat early symptomatic disease, more rapid and accurate diagnosis of AD is becoming increasingly important. A number of different BBM tests are available to clinicians, but the lack of clinical practice guidelines has hindered more widespread use of the diagnostic tools, guidelines authors wrote. A panel of clinical experts, researchers with experience and technical knowledge surrounding BBM, and guideline methodologists conducted a systematic review of the literature to assess the accuracy of BBMs in detecting amyloid pathology for triaging (≥ 90% sensitivity, ≥ 75% specificity) and confirmatory (≥ 90% sensitivity and specificity) diagnostic workup. After a review of 1050 papers, 49 observational studies of 31 different BBM tests were selected for inclusion. The BBMs of interest included plasma phosphorylated-tau (p-tau) and A β tests measuring these analytes: p-tau217, the ratio of p-tau217 to non-p-tau217 ×100 (%p-tau17), p-tau181, p-tau231, and the ratio of Aβ42 to Aβ40. The reference standard tests included CSF, amyloid PET, or neuropathology examination. The relatively low-cost BBM tests are minimally invasive compared with PET and CSF tests and can significantly reduce the physical discomfort and anxiety often associated with lumbar puncture or PET imaging procedures, the authors wrote. The systematic review focused on single analytes, not combinations of different analytes, sometimes referred to a 'blood panel,' noted Edelmayer. Using predefined decision thresholds, the panel determined whether tests have sufficient diagnostic accuracy to be used as a triaging test where a positive test is to be confirmed by PET or CSF, sufficient diagnostic accuracy as a confirmatory test to replace PET or CSF, or insufficient diagnostic accuracy to recommend current use in clinical practice. The recommendations are focused on individuals with either mild cognitive impairment or dementia who are undergoing diagnostic assessment by providers trained and experienced in memory disorders, where AD is the suspected underlying etiology. The guideline does not endorse specific tests or rank them. 'We just don't have enough data at this time,' said Edelmayer. 'We're not ready to pick one single test out of a lineup of tests to say this test is performing much better in a comparative analysis and through systematic review evidence than another test.' Accurate Predictors Researchers now have a clearer picture of how AD pathology evolved over time, with changes in some tau biomarkers occurring very early on, said Edelmayer. 'What we've learned from all of the evidence so far is that some of these biomarkers, like tau 217, tend to be very accurate predictors of Alzheimer's disease biology in the brain, and they can be used to aid in the diagnostic process early on, sometimes even before tau tangle formations can be visualized with brain imaging.' The guideline authors noted some limitations of the evidence. For example, undesirable effects of BBM testing could include false positive or false negative results, which could delay accurate diagnosis and treatment. The authors also cautioned that there's significant variability in the accuracy of diagnostic tests and many commercially available BBM tests do not meet accuracy thresholds. Edelmayer stressed this is the first iteration of the clinical practice guideline and the expert panel is already working on next steps, including determining if these biomarkers can be used as confirmatory or triage tests in cognitively unimpaired people and in a primary care setting. The tests aren't a substitute for comprehensive clinical evaluation by a healthcare professional, said David Knopman, MD, a clinical neurologist and researcher at the Mayo Clinic in Rochester, Minnesota, who commented on the new guidelines for Medscape Medical News . 'The use of any AD-specific biomarker is dependent on the context,' he said. 'For example, the history or no history of cognitive impairment, the objective cognitive assessment, and the presence or absence of features of non-AD biologics.' While he noted the guideline was reasonable for the separate functions of triaging and confirming AD biology, as with any such document, no matter how thoughtfully constructed, there's the risk that people ignore stipulations in the recommendation. 'So people without cognitive impairment will be captured. There's also the risk that the memory disorder clinic is not well versed in non-Alzheimer causes of memory impairment,' he said.
Washington Post
20 hours ago
- Health
- Washington Post
Want to keep your brain sharp as you age? Science may have a recipe.
A mix of exercise, a healthy diet, social engagement and brain games could improve cognitive capabilities in older adults at risk of cognitive decline or dementia, a clinical trial has found. The study, known as U.S. POINTER, is the largest trial to examine how healthy lifestyle behaviors can improve brain health. Its results were published in JAMA and presented at the Alzheimer's Association International Conference on Monday in Toronto.
Daily Mail
2 days ago
- Health
- Daily Mail
Scientists make huge dementia breakthrough as they reveal new jab which could prevent Alzheimer's
A breakthrough new drug could halt the progression of Alzheimer's disease, claim researchers. Trials suggest the drug—called trontinemab—could be the most powerful weapon against dementia yet, slowing down the progression of the memory-robbing disease. Scientists will now consider whether the jab could be given to those who have not yet been diagnosed with the condition in order to prevent symptoms developing in later life. According to research presented at the Alzheimer's Association International Conference, Toronto, the 'game-changing' treatment can clear the toxic plaque thought to be behind Alzheimer's symptoms faster than any other licensed drug. The researchers described the findings as being 'very promising', adding that the drug caused far fewer side effects than existing medications. Professor Sir John Hardy, chairman of neurological disease at University College London, told The Telegraph: 'There is no doubt this could be game-changing. 'It sucks the plaque out of the brain really quickly, much faster then we have seen with [existing medications] lacanemab or donanemab.' In the current trial, 90 per cent of patients prescribed the drug experienced clearance of amyloid—a toxic protein that can form plaques and tangles in the brain, interfering with memory processes—within 28 weeks of starting the treatment. This, experts say, means visible markers of the disease had disappeared. In a follow-up of 18-months, researchers hope these biological changes will facilitate improvements in memory and decision making, with 1,600 patients enrolled on the trial. Currently around one million people in the UK are thought to suffer from dementia, with Alzheimer's disease the most common form. Recent analysis by the Alzheimer's Society estimates the overall annual cost of the dementia to the UK is £42billion a year, with families bearing the brunt. An ageing population means these costs, which include the lost earnings of unpaid carers, are set to soar to £90billion in the next 15 years. But, experts hope that if given early enough, the drug could halt Alzheimer's completely, saving some patients from developing symptoms entirely. 'We hope if we can give these drugs to people early, we can halt the progression of the disease even before people have symptoms,' Prof Hardy—who was the first to identify the role of amyloid in the disease—added. And, because the drug can cross the blood-brain barrier more easily than other current treatments, promising powerful effects at low doses, it could be offered at a far lower price. Together with the lack of side-effects, this could see the drug become the first Alzheimer's treatment to be funded by the NHS, experts say. Prof Hardy continued: 'The results show it is much fast and safer than previous drugs, which means less monitoring. 'That brings down the cost significantly, it means fewer MRI scans, to that would surely mean it could get NICE [National Institute of Health and Care Excellence] approval.' Last year, health watchdogs in the UK gave the green light for two so-called 'wonder' drugs, lacanemab and donanemab which experts claim could slow down the memory-robbing illness in its early stages. Both the drugs use antibodies to clear toxic plaques in the brain—but some experts have warned that donanemab could cause life-threatening brain bleeds in a third of patients. This new drug appears to be a lot safer, scientists say, with less than five per cent of patients suffering complications in the second phase of trials. Prof Jonathan Schott, chief medical officer at Alzheimer's Research UK said: 'The evidence on trontinemab is very promising, showing that the drug can effectively and rapidly clear amyloid from the brain, seemingly with very few side effects. 'We now need to see whether these early stage results carry through to later stage clinical trials, which are planned to start later this year, including in the UK. 'These trials will show whether the drug is not only safe, but impacts on memory, thinking and quality of life.' Levi Garraway, the chief medical officer of the manufacturing company, Roche, added: 'With plans for phase three trials in both early symptomatic and preclinical Alzheimer's disease, we are advancing science with the goal of delaying – and ultimately preventing – progression of this devastating condition.'
Yahoo
2 days ago
- Health
- Yahoo
Federal food assistance program may slow cognitive decline, study suggests
Older adults who participated in the Supplemental Nutrition Assistance Program, or SNAP, had a slower rate of cognitive decline than people who were eligible for the anti-hunger program but didn't receive benefits, according to a study presented Wednesday. Although many adults begin to mentally slow down in midlife, researchers found that people over 50 who participated in SNAP, which helps people with low incomes afford groceries, had a 10% slower rate of decline in their memory and thinking skills compared with their peers. That's equal to gaining two to three additional years of cognitive health over 10 years, said Linlin Da, lead author of the study, who presented her findings Wednesday at the Alzheimer's Association International Conference in Toronto. By providing a secure source of food, SNAP 'may have some underappreciated benefits for brain health,' said Da, who led the study while she was a doctoral student at the University of Georgia College of Public Health. The National Institutes of Health-funded study comes just weeks after President Donald Trump signed legislation that the Congressional Budget Office estimates will cut funding for SNAP, formerly known as food stamps, by $186 billion through 2034. Food banks across the United States are already struggling to meet growing demand amid funding cuts from the Agriculture Department. Food insecurity 'can lead to poor nutrition and chronic disease, and all of that can negatively impact the brain,' Da said. 'So by improving access to nutrient-rich foods, SNAP may support brain health, reduce the stress and promote better health overall.' The new study, which hasn't yet been published in a peer-reviewed journal, leaves many questions unanswered. Researchers didn't measure which foods study participants consumed, so they don't know if people receiving SNAP benefits had healthier diets. But doctors know that high-sodium diets can raise blood pressure, one of the most important risk factors for dementia, said Dr. Mitchell Elkind, chief science officer for brain health and stroke at the American Heart Association. The study also doesn't explain how food security might benefit the brain, said Elkind, who wasn't involved with the research. It's possible that programs such as SNAP relieve the anxiety that people feel when they can't afford their groceries or when they have to choose between paying for food or medication, giving them more mental bandwidth to focus on other issues. Chronic stress has been linked to a higher risk for dementia. The design of the new study, which followed more than 2,300 older people for 10 years, can't definitively prove that participating in SNAP protects brain health. It's possible that people who participated in SNAP were cognitively healthier before the study began, Da said. Enrolling in SNAP can be time-consuming and complicated, making it more difficult for people with cognitive problems to complete their applications. Yet a growing field of research links nutrition, food security and dementia risk. 'Observational studies from around the world have shown us that food insecurity and poor cognitive health go together,' said Kriti Jain, a health administrator at the National Institute on Aging, part of the NIH, who wasn't involved in the study. 'More recent studies have shown us that food insecurity comes before cognitive health gets worse.' Brain health is shaped by far more than genetics, Da said. Cognitive aging 'can also be shaped by policies, by the environment and by access to different resources,' she said. 'That means we can do something to change it and improve it.' Anti-hunger groups contend that cutting SNAP benefits will leave people hungry and less healthy. Research shows that poverty and food insecurity — a condition in which people lack a consistent source of nutritious food —are common risk factors for malnutrition among older adults. 'SNAP is both a lifeline for older adults and a critical public health tool,' said Crystal FitzSimons, president of the Food Research & Action Center, an advocacy group. 'Participating in SNAP can mean extra years of cognitive health, helping older adults remain independent,' instead of moving into nursing homes. The Republican-led House Agriculture Committee has said the funding reduction 'restores SNAP to its original intent—promoting work, not welfare—while saving taxpayer dollars and investing in American agriculture.' Food as medicine Karen Forbes, 61, first participated in SNAP decades ago when she was a single mother of a young child. She reapplied for the program during the pandemic when her pet sitting customers stopped needing her. Forbes, who lives outside Portland, Oregon, said SNAP has been especially important since she developed long Covid in 2022, which has left her with heavy fatigue, prevents her from working and has caused 'brain fog' that resembles age-related cognitive decline. Forbes said she and her father, who is 82, 'are going through a sort of Alzheimer's thing together.' Although Forbes said she used to talk 'a million miles a minute,' she now often struggles to find the right word. If she tries to speak too quickly, 'everything comes out jumbled and stupid.' After an 18-month wait, Forbes said she recently began receiving disability benefits from Social Security. Because of SNAP, Forbes said, she doesn't have to choose between buying groceries and paying her rent or electric bills. Her favorite part of SNAP is being able to afford fresh fruits and vegetables, she said. Oregon's SNAP program provides 'double benefits' for shopping at farmers markets, so people can buy twice as much fresh produce for the same amount of money. Forbes said she tries to follow a healthy diet in the hope of overcoming her illness. 'When you're chronically ill, every little tiny thing you can do to improve your health makes all the difference in the world,' she said. Food insecurity linked to dementia Jain described food insecurity as 'a severe and growing public health issue in America.' In families with member over age 60, the prevalence of food insecurity has almost doubled in the past two decades. Twenty-three percent of such families faced chronic or recurring food insecurity from 2015 to 2019, according to a survey from the NIH published last year in JAMA Health Forum. Another study published last year found that food insecurity doubled the risk of probable cognitive decline. And a paper published in 2024 in the Journal of Nutrition found that adults with food insecurity and lower-quality diets had significantly steeper declines in cognitive scores during the study, conducted from 2012 to 2020. In that study, however, participating in SNAP wasn't related to the rate of mental decline, suggesting that SNAP alone 'may be insufficient to prevent negative cognitive effects of poor diet and limited access to nutritious foods.' Unprecedented cutbacks The Urban Institute, a nonprofit research organization that focuses on social and economic policy, estimates that funding cuts could lead 22.3 million families to lose some or all of their food benefits. The 20% decrease in funding is 'the largest cut to SNAP in history,' according to the Center on Budget and Policy Priorities, a nonpartisan think tank. The measure will also shift much of the program's cost from the federal government to the states beginning in 2028, as well as expand work requirements for participants. Seven in 10 of the 42 million people who participate in SNAP are older adults, people with disabilities and families with children. The new study suggests 'we need more research on the role of healthy diet and nutrition in brain health,' Elkind said. 'In particular, it suggests that there should be more research in the area of food as medicine, meaning the provision of healthy food to people to see what the impact is on cognition, dementia risks and brain health.' This article was originally published on Solve the daily Crossword
Reuters
2 days ago
- Health
- Reuters
Patients still benefit from Eisai and Biogen Alzheimer's drug after four years, study finds
July 30 (Reuters) - Eisai (4523.T), opens new tab and Biogen's (BIIB.O), opens new tab Alzheimer's drug Leqembi continued to slow progress of the disease with no new safety issues four years into treatment, according to new data presented at a medical meeting on Wednesday. An injectable version of the drug, currently given by intravenous infusion, is under U.S. regulatory review. The best results were seen in people who started treatment while in the earliest stages of the brain-wasting disease. In a pivotal trial of patients with early-stage Alzheimer's, Leqembi was shown to slow cognitive decline by 27% compared to a placebo after 18 months - data that supported the drug's U.S. approval in 2023. The companies continued to follow about 95% of patients enrolled in that trial. The latest results show that after four years, Leqembi slowed cognitive decline by 34% compared to what would be expected in similar patients who did not receive treatment. Leqembi targets protofibrils - toxic building blocks that eventually form clumps in the brain known as amyloid plaques, a hallmark of Alzheimer's disease. There were no new safety findings over the four-year period. Brain swelling and bleeding associated with drugs that work by removing amyloid plaque from the brain largely occurred within the first six months of treatment, according to data presented at the Alzheimer's Association International Conference in Toronto. More than 50% of patients who started treatment in the earlier stages of Alzheimer's continued to show improvement in clinical scores after four years on Leqembi. Eisai is conducting a separate study of Leqembi in pre-symptomatic Alzheimer's patients that is due to conclude in late 2027. Eli Lilly (LLY.N), opens new tab is also studying its Alzheimer's drug Kisunla in people who have detectable disease pathology, but show no noticeable cognitive decline. The U.S. Food and Drug Administration, where recent job cuts have raised questions about review times, is slated to decide by August 31 whether to approve an injectable version of Leqembi that could be given to patients at home or at medical facilities. Lynn Kramer, Eisai's chief clinical officer, said interactions with the FDA "have been right on schedule. They have been communicating with us all the time in an expected manner." He said the new formulation "will be very helpful to starting new patients" on the drug, which is continuing to see "escalating usage." Eisai will report its latest quarterly results next week, while Biogen will report results on Thursday.
