There is no cure for Alzheimer’s disease, a type of dementia that affects memory, thinking and behavior. It gets progressively worse over time, but there are medications available to treat early symptoms and to help slow disease progression.
Michelle Mielke, PhD, professor of epidemiology and prevention, Wake Forest University School of Medicine, is leading
incredible research in the diagnosis of Alzheimer’s, and it could potentially result in earlier treatment for some patients. Dr. Mielke and her team are demonstrating our Commitment to Lead the Way by charting new paths to achieve the extraordinary.
“Most research in Alzheimer’s has been done in specialty dementia clinics where individuals are healthier and younger,” Dr. Mielke says. “What we’re trying to understand is how to diagnose the disease in older adults who are on multiple medications and who have other chronic conditions. This is where blood biomarkers come in.”
Biomarkers are characteristics that doctors measure in your blood, body fluids and tissues. They can be signs of conditions, diseases, normal body functions or when something is wrong.
“Our work is leading the way to discover when and how to use biomarkers so we can make a better diagnosis,” Dr. Mielke says. “And that could help some patients get treatment sooner.”
A key biomarker of Alzheimer’s disease is a build-up of abnormal amyloid protein in the brain. Current ways to find this include a lumbar puncture to test for proteins in cerebrospinal fluid (CSF) or amyloid Positron Emission Tomography (PET) imaging.
Most patients with cognitive impairment are treated in primary care because there are a limited number of dementia specialists. But lumbar puncture or other costly tests to check whether cognitive impairment is due to Alzheimer’s are not available in primary care, Dr. Mielke points out. “Blood biomarkers can be accessed in primary care, and nearly anyone can have the test.”
However, doctors do not know when and how to use blood biomarkers to diagnose Alzheimer’s or when additional testing is needed to confirm the diagnosis. Also, when older adults with Alzheimer’s have three or more chronic conditions, this can make a diagnosis challenging. Chronic conditions such as kidney disease or obesity can raise or lower biomarker levels, potentially leading to a false positive or negative result for the disease.
“Our research could open the door to using blood biomarkers to diagnose Alzheimer’s in primary care, where most patients with cognitive impairment seek treatment,” Dr. Mielke says. “That could mean more patients receiving treatment sooner. This could also increase opportunities for patients to participate in clinical trials working to find a cure for the disease.”
