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PUB_Blood-Based Biomarkers

Deborah Kan

Created on March 2, 2025

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Transcript

The guide to

Blood‐based biomarkers for Alzheimer's disease

Understanding blood-based biomarkers

New advances in blood-based testing

What doctors see: Interpreting blood test results

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What are blood-based biomarkers?

Blood-based biomarkers are biological molecules — for example, proteins — that can signal disease-related biological changes in the body and brain.

  • In Alzheimer's disease, proteins like tau and beta-amyloid build up in the brain. Blood-based biomarker tests can help show whether they're appearing in abnormally high levels.
  • Doctors can use these tests to help confirm — or rule out — Alzheimer's disease.

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Read more on beingpatient.com

Benefits of blood-based testing for Alzheimer's

Blood tests are a less invasive testing method that can be done in order to understand whether moving on to procedures like a spinal tap or PET scan is needed.

Less invasive

Blood tests are easier to administer than these other methods. They can be significantly less expensive than other Alzheimer’s diagnostics, too. (Insurance coverage for Alzheimer's blood tests is variable.)

Accessible

Simulation studies suggest blood tests might speed up Alzheimer’s diagnosis and allow people to access disease-modifying drugs sooner.

Clinically valuable

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Read more on beingpatient.com

Core blood-based biomarkers

Proteins like beta-amyloid and tau build up in the brains of people with Alzheimer's. Blood biomarker tests look for a very specific kinds of these proteins. Different ratios mean different things as far as Alzheimer's risk.

Beta-amyloid plaques

Tau protein tangles

There are two forms of beta amyloid protein: Aβ40 and Aβ42. A low Aβ42:Aβ40 ratio of these proteins in the blood suggests that a person may have beta-amyloid plaques in the brain.

pTau-181 and pTau-217 are forms of tau protein. Elevated pTau-217 in the blood strongly correlates with amyloid-beta plaques and tau tangles, the hallmarks of Alzheimer's disease.

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A new landscape of diagnostics

There are a number of blood tests available to doctors and patients, and several are in the pipeline. These didn't initially require FDA clearance/approval, but new tests will.

As of now, tests can be ordered by a doctor. Guidelines do not currently recommend asymptomatic testing.

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Who are Alzheimer's biomarker blood tests for?

Symptomatic patients

Patient with cognitive symptoms who has established care

People with cognitive symptoms can benefit from these tests: They help clinicians assess the likelihood of Alzheimer's disease and determine appropriate next steps in the diagnostic process.

Keep in mind: Results can be affected by

  • Other health conditions (i.e. kidney disease)
  • Certain medications, especially heart medications
  • Individual variations that are perfectly normal

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Who should get an Alzheimer's biomarker blood test?

Neurologist's perspective

The first thing is, I split symptomatic people from non-symptomatic people. In my practice, of course, I'm seeing fully symptomatic, mild cognitive impairment, and dementia. The blood tests are part of the diagnostic work-up — much like an MRI, much like a PET scan, etcetera. So if they're symptomatic, that's how I'm using the tests.

Dr. Marwan Sabbagh

Professor and the Vice Chair of Research, Barrow Neurological Institute

watch the video

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Where in the diagnostic process does a blood biomarkers test come in?

This type of test is new. Experts are currently in the process of developing appropriate use recommendations. In general, the tests are provided to patients who have memory symptoms after a doctor has ruled out other potential causes of memory impairment like vitamin or hormone deficiency, sleep apnea, depression, and other medical conditions.

Read more

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How it works: For patients

1. Quick blood draw (just like routine bloodwork)

2. Lab analysis(1 to 2 weeks)

3. Review results with doctor

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Advice for patients and caregivers

Discuss any memory or cognitive concerns during regular check-ups. Work with your doctor to determine if further testing is needed. Early discussions help explore available blood testing options and plan ahead.

Consult your doctor

Professional assessment

Plan proactively

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The future of Alzheimer’s diagnostics

Blood-based biomarkers show great potential in advancing Alzheimer's detection and care and helping people get accurate diagnoses, earlier.

  • Ongoing research involves improving test accuracy and developing finger-prick tests that could make the process easier
  • Once blood tests are cleared/approved by the FDA, they may be covered by Medicare making them more affordable

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Want to learn more?

Visit

beingpatient.com

for the latest news and information on brain health and dementia

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Initial screening test

To help clinicians understand whether Alzheimer's is a possibility at the start of a diagnosis process for people showing cognitive symptoms.

Purpose

To confirm the presence or absence of Alzheimer's pathology after a doctor has done other tests

Negative result

Positive result

- Low likelihood of Alzheimer's- Regular monitoring advised

- Further evaluation needed- Additional diagnostic tests

Intermediate result

- Repeat testing in the future- Possible interfering factors

Purpose

To help clinicians understand whether Alzheimer's is a possibility at the start of a diagnosis process for people showing cognitive symptoms.

Negative result

Positive result

Initial test shows no concerning levels of biomarkers - No immediate concerns identified - Continue routine health monitoring

Initial test indicates potential presence of biomarkers- Referral to specialist recommended - Additional confirmation testing needed - Does not confirm diagnosis