Published 23 August 2024 at 10.57
Domestic. A blood test that was previously shown to give as good results as a spinal fluid test for identifying Alzheimer's disease has now been tested in regular healthcare.
– The accuracy rate was around 90 percent even in primary care. This can have great significance for all those who seek care with memory impairment and suspected Alzheimer's, say the researchers behind the study.
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Research into the new blood test method that measures the levels of the substance phospho-tau217 began in 2019. The researchers who developed the blood test have shown that Alzheimer's changes can be detected even before clear symptoms break out, but that the levels in the blood gradually increase as the disease progresses.
Now the researchers have investigated how accurate the blood test is when it is used strictly within the usual healthcare, and they have then studied both primary care and specialist care. The study is published in the respected journal JAMA.
– The results show that the blood test can answer with 90 percent accuracy whether a person with memory problems has Alzheimer's or not, says Sebastian Palmqvist, associate professor and lecturer in neurology at Lund University and senior physician at Skåne University Hospital.
He has led the study together with Professor Oskar Hansson.
A total of 1,213 people who sought care for memory impairment, which can be symptoms of incipient Alzheimer's, were included in the study. 515 were investigated in primary care and 698 in a specialized memory clinic. These were tested with the current blood sample and the test results were then confirmed with spinal fluid samples that can demonstrate Alzheimer's pathology. About half of the people had Alzheimer's changes in the brain.
The next step will now be to draw up clear clinical guidelines for how the blood sample should be used in healthcare.
– An early diagnosis is becoming increasingly important as new disease-slowing treatments are developed. In the USA, for example, a new immunotherapy has been approved, and these will hopefully be available in Europe relatively soon. But it is also important to be able to research new treatments, says Oskar Hansson, professor of neurology at Lund University, who is also chief physician at Skåne University Hospital.
The blood test's accuracy of just over 90 percent in identifying Alzheimer's disease was compared with the doctors' assessment in primary care or specialist care before they were able to see the results of the blood test or spinal fluid test.
– The accuracy of the primary care doctors in identifying Alzheimer's disease was 61 percent, while the specialist doctors were right in 73 percent of the cases. This highlights the need for good and cost-effective diagnostic tools, above all in primary care, and what improvement can be achieved if you start using a blood test like this in healthcare, says Sebastian Palmqvist.
To rule out Alzheimer's through a simple, accurate blood testing that can be done in primary care is also important for the patient and the attending physician. Memory difficulties can be due to other treatable causes, for example depression or fatigue syndrome.
– The next step will now be to develop clear clinical guidelines for how the blood test should be used in healthcare. The blood sample is expected to be available for doctors in Sweden to order in the fall, and I think they will then start using it fairly soon in specialized memory clinics. It will probably take around 1-2 years before guidelines and training initiatives are in place in primary care, says Oskar Hansson.
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