A groundbreaking two-step method for diagnosing Alzheimer’s disease has been developed, aiming to minimize invasive tests and unnecessary procedures. Published in the prestigious journal ‘Nature Aging’, the research findings have been hailed as an important step forward in improving diagnostic testing for this debilitating condition.
Scientists from the University of Gothenburg in Sweden teamed up with researchers from Canada to devise a more accurate and efficient diagnostic approach for Alzheimer’s disease. Currently, a blood screening test called p-tau217 biomarker is used to detect the presence of amyloid protein, which is responsible for organ damage in Alzheimer’s patients. However, this method is not without its drawbacks, as it is less precise and often leads to unnecessary invasive tests.
In a bid to address these challenges, the research team proposed a two-step diagnostic approach. This innovative method takes into account other risk factors for Alzheimer’s and combines them with the p-tau217 test. For individuals whose risk of the disease is uncertain, a cerebrospinal fluid test is conducted as the second step.
The study analyzed data from 348 patients with mild cognitive impairment who participated in the BioFINDER study. To ensure accuracy, participants with substance use disorders, those who refused neuropsychiatric testing, and individuals with neurological abnormalities unrelated to Alzheimer’s disease were excluded from the analysis. The focus was on individuals with data on the p-tau217 biomarker, cerebrospinal fluid tests, and the APOE e4 gene, a genetic risk factor for Alzheimer’s.
The first step of the two-step approach involved evaluating the risk of a positive amyloid PET test result in patients with mild cognitive impairment. This was done by considering age, plasma p-tau217 information, and APOE e4 information. The amyloid PET test is known to identify a high-risk group for Alzheimer’s disease. The researchers then grouped participants into low risk, moderate risk, and high risk based on their risk level and proceeded to the second step.
In the second step, the research team checked the Ab42/40 ratio in the cerebrospinal fluid of the intermediate risk group. They performed screening tests with different sensitivity thresholds to assess the accuracy of the diagnostic models. The results showed increased accuracy with higher screening sensitivity, reaching 88.2%, 90.5%, and 92.0% for PET amyloid positivity.
It is worth noting that as the sensitivity of the screening test decreased, the need for cerebrospinal fluid testing decreased by approximately 85.9%, 72.7%, and 61.2%. This implies that the two-step approach effectively reduces the reliance on invasive tests, such as cerebrospinal fluid biomarkers or PET scans, while maintaining a high level of accuracy in identifying high-risk groups for Alzheimer’s disease.
This groundbreaking research offers hope for improved diagnosis and treatment of Alzheimer’s disease. By minimizing unnecessary invasive tests, patients can be diagnosed more accurately and efficiently, leading to timely interventions and better patient outcomes. The two-step approach has the potential to revolutionize the field of Alzheimer’s diagnostics, bringing us one step closer to conquering this devastating condition.
Today’s medical correspondent, Jaebaek Choi.
▲ Research results have shown that a two-step diagnostic method for diagnosing Alzheimer’s disease has been devised while reducing unnecessary invasive tests. (Photo = DB)
[메디컬투데이=최재백 기자] A two-step diagnostic approach to diagnose Alzheimer’s disease while minimizing unnecessary invasive testing has been proposed.
Research results showing a two-step diagnostic approach for diagnosing Alzheimer’s disease while reducing unnecessary invasive tests have been published in ‘Nature Ageing’.
Recently, a research team from the University of Gothenburg, Sweden, focused on improving diagnostic tests for Alzheimer’s disease in collaboration with Canadian researchers.
The p-tau217 biomarker blood screening test, a current test method for diagnosing Alzheimer’s disease, is a test that checks for the accumulation of amyloid protein which can cause organ damage, but has the disadvantage of being less accurate and leading to to unnecessary invasive tests.
To improve this, the research team proposed a two-step diagnostic approach that comprehensively considered other risk factors for Alzheimer’s disease in addition to the p-tau217 test and then carried out a cerebrospinal fluid test for people at risk uncertain.
They analyzed data from 348 patients with mild cognitive impairment from the BioFINDER study. Participants who had a substance use disorder, refused neuropsychiatric testing, or had neurological abnormalities due to factors other than Alzheimer’s disease were excluded from the analysis.
The research team focused on participants with data on the plasma biomarker p-tau217, which is linked to the development of Alzheimer’s disease, cerebrospinal fluid tests, and APOE e4, a genetic risk factor that helps diagnose Alzheimer’s disease.
Subsequently, as the first step of the two-step diagnosis approach, the risk of a positive amyloid PET test result in patients with mild cognitive impairment was evaluated using age, plasma p-tau217 information, and APOE e4 information. A positive amyloid PET test identifies a high-risk group for Alzheimer’s disease.
The researchers predicted that the intermediate risk group, where risk is uncertain, would be the best group to improve diagnostic models and reduce misdiagnosis. Therefore, they classified the participants into low risk, moderate risk, and high risk groups according to their risk, and then followed the second step to check the Ab42/40 ratio in the cerebrospinal fluid of the intermediate risk group.
They performed screening tests with different sensitivity thresholds (low, medium and high sensitivity) to determine the difference between false positives and false negatives, with higher screening sensitivity with PET amyloid positive accuracy of 88.2%, 90.5%, and 92.0%, They said that it rises in order.
Meanwhile, they added, as the sensitivity of the screening test decreased, the required cerebrospinal fluid test decreased by approximately 85.9%, 72.7%, and 61.2%.
The research team expected that the two-step diagnostic approach would reduce invasive testing using cerebrospinal fluid biomarkers or PET scans while maintaining high accuracy in diagnosing high-risk groups for Alzheimer’s disease.
Today’s Medical Correspondent Jaebaek Choi (jaebaekchoi@naver.com)
[ⓒ 메디컬투데이. 무단전재-재배포 금지]
#Designing #twostage #diagnostic #approach #select #highrisk #groups #Alzheimers #disease
