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Alzheimer’s Association Talking Points
Possible blood based biomarkers panel for pre-clinical Alzheimer’s disease
Nature Medicine, March 9, 2014
On Sunday, March 9, the journal Nature Medicine will publish results of a study investigating bloodbased biomarkers that may distinguish cognitively normal people who will progress to either amnestic
mild cognitive impairment (MCI) or Alzheimer’s disease. The authors say this is the first published report
of a biomarker panel of this type with this high level of accuracy (90%) for detecting preclinical
Alzheimer’s.
The authors also state that, “[t]his biomarker panel requires external validation using similar rigorous
clinical classification before further development for clinical use. Such additional validation should be
considered in a more diverse demographic group than our initial cohort.”
We have received many inquiries from news media about this article.
Alzheimer’s Association Leadership in This Area
In April 2012, the Alzheimer’s Association and the Alzheimer’s Drug Discovery Foundation convened top
scientists from around the world to discuss the state of blood based biomarker development. A
manuscript from this session was published in January 2014 in Alzheimer’s & Dementia: The Journal of
the Alzheimer’s Association that summarizes the meeting and the resultant discussion, including
potential next steps to move this area of research forward. The article is “free access” this week only at:
http://www.alzheimersanddementia.com
In addition, the Alzheimer's Association International Society to Advance Alzheimer's Research and
Treatment (ISTAART) has a Professional Interest Area (PIA) on blood-based biomarkers:
https://act.alz.org/site/SPageServer?pagename=ISTAART_PIA_BBB
Key Messages

The Alzheimer’s disease field needs methods to detect and diagnose Alzheimer’s at its earliest
timepoint in order to allow earlier intervention with new treatments and future potential
prevention strategies. The field also needs these tools to enhance and speed the development of
new therapies that can slow, stop or prevent the disease.

Current biological markers for early disease detection -- including levels of abnormal proteins in
cerebrospinal fluid, structural and functional MRI of the brain, and brain PET amyloid imaging -- are
limited by their inability to specifically diagnose (“rule in”) the disease, or because they are invasive
and can be expensive.
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
There is a clear need for widely available, inexpensive and reliable methods to diagnosis Alzheimer’s
disease in the earliest stages, track disease progression, and accelerate clinical development of new
therapeutics. One avenue of research being explored is blood-based biomarkers.

Blood-based biomarkers would be a great and useful option -- more accessible, less invasive, easier
to gather, and less expensive to process. Several are under development for Alzheimer’s disease,
including preclinical Alzheimer’s. More research investment in this area is urgently needed.

The Nature Medicine article (“Plasma phospholipids identify antecedent memory impairment in
older adults”) reports on a novel blood-based biomarker panel. The results, while intriguing, are
preliminary. They require replication and validation by other scientists in larger and more diverse
populations to give them credibility, before further development for clinical use is warranted.

We are in the early days of discovery in this area of Alzheimer's research. Much more research is
needed in this exciting and potentially useful area -- on this panel, on the others that are in
development, and on uncovering and verifying additional blood-based biomarkers for Alzheimer's.

On July 12-17, the global Alzheimer’s research community will gather at the Alzheimer’s Association
International Conference in Copenhagen. At the conference, we will learn more about the very
latest in early detection and diagnosis, as well as causes, risk factors, treatment and prevention of
Alzheimer’s and other dementias.

The Alzheimer’s Association is the world’s leading voluntary health organization in Alzheimer's care,
support and research. Our mission is to eliminate Alzheimer’s disease through the advancement of
research, to provide and enhance care and support for all affected, and to reduce the risk of
dementia through the promotion of brain health. Our vision is a world without Alzheimer’s. Visit
www.alz.org or call 800.272.3900.
More about the Study
The study started with 525 healthy participants aged 70 and older who gave blood samples upon
enrolling and at various points in the study. Over five-years, 74 participants met the criteria for either
mild Alzheimer’s disease or amnestic mild cognitive impairment (aMCI). Of these, 46 were diagnosed
upon enrollment and 28 developed aMCI or mild Alzheimer’s during the study (the latter group called
“converters”).
In the study’s third year, the researchers selected 53 participants who developed aMCI/Alzheimer’s
(including 18 converters) and 53 cognitively normal matched controls for the biomarker discovery phase
of the study. A panel of 10 lipids (fats) was selected, which the researchers say appears to reveal the
breakdown of neural cell membranes in participants who develop symptoms of cognitive impairment or
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Alzheimer’s. The lipid biomarker panel was validated using the remaining 21 aMCI/Alzheimer’s
participants (including 10 converters), and 20 controls.
According to the researchers, the lipid panel was able to distinguish two distinct groups: (1) cognitively
normal participants who would progress to MCI or AD within two to three years, and (2) those who
would remain normal in the near future with 90 percent accuracy.
(end)
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