Study confirms accuracy of blood test for early Alzheimer's detection in Asian populations

A study in Alzheimer's & Dementia, a leading journal in dementia research, has demonstrated the high accuracy of plasma p-tau217 as a blood-based biomarker for detecting abnormal brain beta-amyloid (Aβ) pathology, a hallmark of Alzheimer’s disease (AD). More significantly, the study validates its effectiveness even in individuals with cerebrovascular disease (CeVD), which is highly prevalent in Asian populations. This finding can enhance early diagnosis, improve patient risk stratification, and facilitate better clinical management of AD in diverse populations.

The study was led by Dr Mitchell Lai, Senior Lecturer at the Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), in collaboration with local and international experts from the National University Health System (NUHS), University of Gothenburg, Institute of Neurology at University College London, and Banner Sun Health Research Institute.

Bridging gaps in Alzheimer’s research for Asia

While blood biomarkers like p-tau217 have been extensively studied in Western populations-where CeVD is less common-this study uniquely focuses on a Singapore-based cohort, reflective of broader Asian demographics with a high CeVD burden. The results confirm that higher plasma p-tau217 levels correlate with faster cognitive decline, reinforcing its role not just as a diagnostic tool but also as a potential predictor of disease progression.

Transforming Alzheimer’s diagnosis: A potential game-changer for clinical practice

Potential clinical applications include:

• Earlier and more precise detection: Plasma p-tau217 provides a highly sensitive and specific method for identifying Alzheimer’s pathology before severe cognitive decline occurs, potentially enabling earlier intervention and monitoring.

• A simpler, minimally invasive diagnostic tool: Unlike costly and invasive positron emission tomography (PET) scans and cerebrospinal fluid tests, a blood-based biomarker could be easily integrated into routine clinical practice, making Alzheimer’s screening more accessible and scalable.

• Patient risk stratification for optimised, personalised care: Adding plasma p-tau217 to routine clinical assessments allows doctors to efficiently categorise individuals into low, intermediate, and high-risk groups for Aβ pathology, enabling tailored follow-up strategies and potential early therapeutic interventions for patients.

Professor Christopher Chen, Director of the Memory, Ageing and Cognition Centre at NUHS and co-author of the study, said “This study provides strong evidence that plasma p-tau217 could be a game-changer for early detection of AD brain changes in Asian populations with high CeVD burden. A blood-based biomarker like p-tau217 brings us closer to a more accessible approach to diagnosing and managing AD in Singapore and beyond”.

Dr Joyce Chong, a Research Fellow with the Department of Pharmacology, NUS Medicine, and first author of the study, added “Although blood biomarkers are not expected to replace the current gold standard in clinical measures such as amyloid PET, their greatest value may lie in providing a cost-effective, minimally-invasive screening and risk-stratification tool to help reduce the proportion of individuals requiring confirmatory PET scans.”

Looking forward, the team hopes to expand the study both in the length of follow-up, as well as the diversity of investigated biomarkers. Dr Lai said, “There is increasing awareness that dementia is a chronic condition arising from complex, interacting processes, especially in our population where CeVD is likely to be an important contributor to the cognitive impairments associated with AD. Our long-term goal is to be able to produce a panel of multi-modal, clinically useful biomarkers which can both suggest novel therapeutic targets as well as help in the diagnosis and prognosis of this debilitating condition.”

Reference:

Joyce R. Chong, Saima Hilal, Boon Yeow Tan, Narayanaswamy Venketasubramanian, Michael Schöll, Henrik Zetterberg, Kaj Blennow, Nicholas J. Ashton, Christopher P. Chen, Mitchell K. P. Lai, Clinical utility of plasma p-tau217 in identifying abnormal brain amyloid burden in an Asian cohort with high prevalence of concomitant cerebrovascular disease, Alzheimer s & Dementia, https://doi.org/10.1002/alz.14502