Study finds blood test diagnosed Alzheimer's disease 90% of the time; early diagnosis is crucial with new medications available

2024 Alzheimer's disease facts and figures
special report graphic

By Melissa Patrick
Kentucky Health News

A new blood test can diagnose Alzheimer's disease better than a memory specialist or a primary care physician, according to a new study. 

The study, published in the Journal of the American Medical Association, found that the blood test, called PrecivityAD2, was 90% accurate in diagnosing Alzheimer's disease, compared to a 61% success rate among primary care doctors and a 73% success rate among memory specialists. All of the physicians used standard clinical methods for diagnosis that did not include brain scans or spinal taps. 

The researchers at Lund University in Sweden followed 1,213 people with an average age of 74 who were undergoing cognitive evaluations in both primary care and specialty clinics in Sweden.

Dr. Greg Cooper, director of the Norton Neuroscience Institute Memory Center in Louisville, explained that there are protein biomarkers that are indicative of Alzheimer's disease and can be identified through a a spinal tap, which is invasive, or a brain scan called a PET scan, which he said are not always available, are expensive and are not well-covered by insurance. 

But now, he said, there is a blood test that can accurately detect these biomarkers. The blood test works by measuring a combination of two ratios within a blood sample, including the phosphorylated tau protein and two amyloid-beta proteins, both considered  hallmarks of Alzheimer's disease. 

"Most people would prefer a blood test over a spinal fluid exam, a spinal tap," he said. 

Cooper added that the blood test should be used only on people who show signs of memory loss or have a diagnosis of mild cognitive impairment or dementia. In this group, he said, "It is a very accurate test." 

Further, he said this blood test will help people get an early diagnosis, which is needed to qualify for the two new drugs approved to modestly slow the symptoms of Alzheimer's: Leqembi and Kisunla. At this time, Cooper said it can take months or even years before a person can receive a diagnosis. 

"As newer medications become available . . . we need to do a better job of identifying people very early on, when they are the best possible candidates for these medications that we believe actually slow the progression of the disease."

According to the Alzheimer's Association, nearly 7 million Americans are living with Alzheimer’s disease, with this number projected to rise to nearly 13 million by 2050. In Kentucky, the association reports that 81,000 people aged 65 and older are living with Alzheimer's.

Cooper said the Norton memory center is already using this blood test, but there remains some barriers.

"The biggest barrier right now has been in terms of payments," he said. "So we are using this exact same test that was used in this study and the results are really quite good. But payment is an issue.Insurance does not always cover this and so there is often an out-of-pocket expense."

He said he is hopeful that with studies like this one and future U.S. Food and Drug Administration approval, insurance will eventually pay for it. " I think it is only a matter of time before insurance starts paying for it, "he said. "At this time, it's just simply too new." 

He said it "remains to be determined" if primary care doctors should do this blood test, largely related to their ability to do cognitive memory testing in their practices. With the advent of these new medications that require early diagnosis, he said there is a sense of urgency to diagnose people early on and a patient's first point of contact is often their primary care provider. 

"The worst thing in the world is to tell someone had I seen you six months or a year earlier, you might have been a candidate for one of these new treatments -- and now you're not," he said. "Tests like this will help accelerate that process and allow more people to benefit from these therapies."

Recognizing that many people are afraid of getting an Alzheimer's diagnosis, Cooper said: "I would simply argue that not receiving a diagnosis, if you have that underlying disease, doesn't make the disease go away. You can't ignore it. It will catch up with you eventually. But now, we have opportunities to take a proactive approach. Maybe we can't cure it, but we can do things that meaningfully impact the disease and can meaningfully impact and promote our quality of life. So it is an awful diagnosis, I can't take that away. But we can't help unless we take that first step. And so always keep in mind, there may be things that we can do. Don't run away from that." 

Study identifies six factors linked with lower risk of dementia; expert says 'It may never be too late to improve your brain health'

A new study of more than 29,000 older adults in China has identified six habits "that are linked with a lower risk of dementia and a slower rate of memory decline," Annabelle Timsit of The Washington Post reports. "Eating a balanced diet, exercising the mind and body regularly, having regular contact with others, and not drinking or smoking . . . were associated with better cognitive outcomes in older adults." Specifially, the six modifiable lifestyle factors were:

• Exercise: At least 150 minutes of moderate activity or 75 minutes of vigorous activity per week.
• Diet: Appropriate daily amounts of at least seven of 12 food items (fruits, vegetables, fish, meat, dairy products, salt, oil, eggs, cereals, legumes, nuts and tea).
• Alcohol: Never drank, or drank occasionally.
• Smoking: Never smoked, or a former smoker.
• Cognitive activity: Exercising the brain at least twice a week (examples: reading and playing cards).
• Social contact: Engaging with others at least twice a week (examples: attending community meetings or visiting with friends or relatives).

The study was conducted from 2009 to 2019 and published in the British Medical Journal. "While researchers have long known that there is a link between dementia and factors such as social isolation and obesity, the size and scope of the new study adds substantial evidence to a global body of research that suggests a healthy lifestyle may help brains age better," Timsit writes. "It also suggests that the effects of a healthy lifestyle are beneficial even for people who are genetically more susceptible to memory decline — a 'very hope-giving' finding for the millions of individuals around the world who carry the APOEε4 gene, a major risk factor for Alzheimer’s disease, said Eef Hogervorst, chair of biological psychology at Loughborough University, who was not involved in the study."

Timsit notes, "Memory naturally declines gradually as people age. Some older people may develop dementia, an umbrella term that can include Alzheimer’s, and generally describes a deterioration in cognitive function that goes beyond the normal effects of aging. But for many, 'memory loss can merely be senescent forgetfulness,' write the authors of the BMJ study — like forgetting the name of that TV program you used to love, or that pesky fact you wanted to look up.

"Memory loss is no less damaging for being gradual, and age-related memory decline can in some cases be an early symptom of dementia. But the good news, the researchers say, is that it 'can be reversed or become stable rather than progress to a pathological state.' . . . At the start of the study, researchers conducted baseline memory tests as well as testing for the APOE gene. They also surveyed participants about their daily habits. Participants were sorted into one of three groups — favorable, average and unfavorable — based on their lifestyle. Over the course of the study, the researchers found that people in the favorable group (four to six healthy factors) and average group (two to three) had a slower rate of memory decline over time than people with unfavorable lifestyles (zero to one healthy factor). People living favorable lifestyles that included at least four healthy habits were also less likely to progress to mild cognitive impairment and dementia. . . . Notably, this held true even for people who carried the APOE gene associated with a higher risk of Alzheimer’s disease.

"Some of the study’s findings differ from the results of other large studies conducted in the United States and in Europe, says Hogervorst. For instance, the BMJ study found that the lifestyle factor with the greatest effect on reducing memory decline was a balanced diet. Other studies have suggested that diet matters less in old age than physical and mental exercise, says Hogervorst. Still, its results align with the broad scientific consensus that there is a link between how we live and our cognitive function as we age — and perhaps more important, suggest that it may never be too late to improve your brain health."

Jury awards family of Paducah nursing-home patient $2.2 million for negligence; defense attorney says the case isn't over

A jury ordered a Paducah nursing home Aug. 9 to pay more than $2.2 million in damages "for gross negligence and failure to provide proper care to a 92-year-old woman with dementia," reports Dave Thompson of The Paducah Sun.

Mary Opal Moore

Mary Opal Moore lived at Superior Care Home for "just over three months in 2014 and 2015," Thompson reports. The lawsuit by her family alleged that she received inadequate care and was evicted after she qualified for Medicaid, which generally pays less than providers' costs, and that those acts led to her death less than a month later, by accelerating her mental and physical decline.

Louisville attorney Tad Thomas told Thompson after the trial that the family took Moore to the home at a cost of more than $9,000 a month partly because it advertised a new "memory-care facility" with "specialists who knew how to care for people with dementia and Alzheimer's" disease, but the treatment was inadequate.

"She was needing more care, and at the same time the facility was going to make a lot less money," Thomas said.

The McCracken Circuit Court jury awarded $1,625,000 in punitive damages and more than $580,000 in compensatory damages for pain, suffering and medical expenses.

"Paducah attorney Eddie Jones, who represented the nursing home and its owners Helen Sims and Michael Sims, said expert witnesses testified the nursing home provided 'exceptional care,' and also disputed the idea that Moore was kicked out due to her Medicaid status," Thompson reports. "Jones said . . . the facility was attempting to transfer her to another facility's geriatric unit with her doctor's agreement."

Jones told the Sun that he expects post-trial litigation. That could include an appeal to the state Court of Appeals or a motion to set aside the verdict.

Kids who quit pot for a month improved memory, study finds

Photo by Sharon McCutcheon, Unsplash.com

A small-scale study suggests that when young marijuana smokers stop for a month, their memory improves. "The results show that not only does marijuana impair teenagers’ and young adults’ abilities to take in information, but that this memory muddling may be reversible," Science News reports.

One week into the experiment, those who abstained from pot "performed moderately better on memory tests than they had at the beginning of the study," reports Laura Sanders of Science News. "One particular aspect of memory, the ability to take in and remember lists of words, seemed to drive the overall improvement. . . .  Tricky tasks that required close monitoring of number sequences, and the directions and locations of arrows" did not seem to be affected.

"Scientists have struggled to find clear answers about how marijuana affects the developing brain, in part because it’s unethical to ask children to begin using a drug for a study," Sanders notes. So the researchers recruited 88 people 16 to 25 years old who reported using marijuana at least once a week, and offered 62 of them money to quit for a month. "Participants were paid more money as the experiment went along, with top earners banking $585 for their month without pot. . . . Urine tests showed that 55 of the 62 participants stopped using marijuana for the 30 days of the experiment."

The researchers from Massachusetts General Hospital and Harvard Medical School published their study in the Journal of Clinical Psychiatry.

Neuropsychologist April Thames of the University of Southern California told Science News that the study raises many interesting questions, such as whether there is a "point of no return" for the developing brain: “If somebody is using very heavily over a prolonged period of time, is there a point at which these functions may not recover?”

The researchers plan to conduct longer-term studies to answering that and other questions, Sanders reports: "While there’s still much to learn about how marijuana affects developing brains, the latest results suggest caution is needed, especially at a time when, as laws change, marijuana is becoming increasingly available in the United States and other countries."

“We should really be urging kids to delay using cannabis, particularly high-potency products, for as long as possible,” said neuropsychologist Randi Schuster, the lead researcher on the study.

Free lecture Tuesday, Jan. 12, in Louisville to discuss differences between forgetfulness and Alzheimer's; with time for Q&A

A behavioral health expert will sponsor a free lecture and question and answer session in Louisville Jan. 12 to explain the difference between the temporary forgetfulness that comes with aging and symptoms of age-related memory disorders, like Alzheimer's.

The event, "Memory, Aging and Alzheimer's Q&A," will begin at 7 p.m., Tuesday, Jan. 12, in Room 251 of Second Presbyterian Church, 3701 Old Brownsboro Rd. It is sponsored by the University of Louisville Depression Center, and will be led by Dr. Ben Schoenbachler, associate professor in the U of L Department of Psychiatry and Behavioral Sciences.

A 2015 study found that more than 75 percent of people can’t distinguish between signs of Alzheimer’s and the usual forgetfulness that comes with aging, according to the release. Schoenbachler’s presentation is meant to help participants learn more about those differences.

Alzheimers Association graphic

According to the Alzheimer's Association, there are over 68,000 Kentuckians with Alzheimer's disease; this number is expected to increase to 86,000 by 2025.

For more information, contact the Depression Center at 502-588-4450.

Eating trans fat weakens memory in younger men, study says

Trans fats, the use of which the U.S. Food and Drug Administration limited last month, are associated with reduced memory function in men 45 and younger, says a University of California San Diego School of Medicine study published in the online journal PLOS ONE.

Researchers asked 1,018 men and women to fill out a dietary survey and take a word-recall memory test. Men 45 and younger remembered an average of 86 words, but for each additional gram of trans fats eaten daily, memory dropped by 0.76 words. Compared to the men who didn't consume trans fats, those in the study who consumed the most recalled 12 fewer words.

"Trans fats were mostly strongly linked to worse memory in men during their high-productivity years," said Beatrice A. Golomb, lead author and professor of medicine at UCSD. "Trans fat consumption has previously shown adverse associations to behavior and mood—other pillars of brain function. However, to our knowledge a relation to memory or cognition had not been shown."

Other research has shown that trans fatty acid consumption is linked to negative effects on lipid profile, metabolic function, insulin resistance, inflammation and cardiac and general health. "As I tell patients: While trans fats increase the shelf life of foods, they reduce the shelf life of people," Golomb said.

The Homeplace at Midway opens, with cottages for nursing, assisted living, memory care; first 'Green House' facility in Ky.

By Kacie Kelly and Al Cross
University of Kentucky School of Journalism and Telecommunications

The Homeplace at Midway was formally opened Thursday, June 25, bringing to fruition a 16-year campaign for a nursing home in the Woodford County town of 1,700. For photos from its June 28 open house, click here.

Construction this spring (Christian Care Communities photo)

The Homeplace, which has four residential buildings that look like single-family homes, is more than a nursing home. Two of the buildings are for skilled nursing, but one is for assisted living and the other is for "memory care" or personal care of patients with dementia and other cognitive impairments.

“The Homeplace at Midway represents a new beginning for older adults in Kentucky and for communities across the commonwealth to embrace them as living treasures, not a burden or a challenge,” Dr. Keith Knapp, president and chief executive officer of Christian Care Communities, which built the Homeplace and will operate it, said at the ribbon-cutting ceremony.

Assisted living cottage (Photo by Kacie Kelly)

“We are extremely grateful to the City of Midway, the Midway Nursing Home Task Force, Midway College, state and local government agencies, our capital campaign’s Leadership Council and all our friends and supporters who championed this new direction and envisioned with us a new day when older adults would receive the highest quality care and support, without feeling their lives are being disrupted or overtaken,” Knapp said. “We trust that it will inspire other senior living providers to move in a similar direction.”

The Homeplace is the first facility in Kentucky built with The Green House model, which includes home-like environments and strong relationships with caregivers, with the goal of meaningful lives for residents. Dr. William Thomas, creator of the model, told the crowd at the event, “The Homeplace, with its emphasis on home, shows how care can be made more loving, community centered and effective.”

One of the two skilled-care cottages (Photo by Kacie Kelly)

Patients have been moving in all month. The staff at The Homeplace is trained to use the “best friend approach,” Laurie Dorough, the facility's community-relations manager, said in an interview. Staff and volunteers are to treat residents as they would treat a best friend.

Knapp said at the ribbon-cutting, “Each resident will have a private bedroom and bath and share, just as people do in any home, the kitchen, living room, den and porch areas. It’s all designed to give residents the freedom to set their own daily routines and to live life to its fullest, while receiving the individual care they need – within each cottage.

The assisted-living cottage is larger than the others, to provide room for more activities and “the potential for spouses to live there,” said Laurie Dorough. “It’s kind of the first step out of independent living,” she said. The cottage has an open kitchen where residents can get involved with meal preparation or “come out and see what’s cooking.”

Skilled-care cottage bathroom lift system (Photo by Kacie Kelly)

The skilled-nursing cottages have bedrooms with medicine cupboards rather than medical carts, and a bathroom lift system (photo at right) that takes the resident straight to their own bathroom. The bedrooms are relatively small, an incentive for residents to spend more time in the communal living space.

The Homeplace campus, across Weisenberger Mill Road from Midway College, also includes an administrative cottage and the Lucy Simms Lloyd Gathering House for special gatherings, worship services and activities.

Between the cottages is the courtyard, with lighted walking paths from building to building, a gazebo, and space for outdoor activities. “Our hope is to maybe start a community garden,” said Dorough.

The long campaign for a nursing home, led by the Midway Nursing Home Task Force, began to see success in 2010 when Louisville-based Christian Care agreed to be the developer. Christian Care has facilities in 11 Kentucky cities, and a church-outreach program with more than 230 churches as partners.

The Homeplace will have a partnership with Midway College, which becomes Midway University July 1. “We are excited to work with Midway College to not only provide learning opportunities for students but also for the residents of The Homeplace,” said Tonya Cox, the facility's executive director.

The Homeplace will be offering internships and other learning opportunities for students. This partnership will also benefit residents, Cox said: “Our residents will also have the opportunity to attend events and classes to foster their lifelong learning.”

Cox said The Homeplace aims to provide “unique long-term care in a way that honors their preferences and desires to be home.” More information is on the facility's website. It will host an open house from 1 to 3 p.m. Sunday, June 28.

'Mind Matters' Health Fair in Lexington May 18 will focus on brain and nutrition; famous chef will make free "brain healthy" food

Ouita Michel

Nationally known Bluegrass chef Ouita Michel of Midway, who owns seven Lexington-area eateries, will be cooking up free "brain healthy" food at the seventh annual "Mind Matters" Health Fair Monday, May 18 at the Fayette County Extension Office, 1140 Red Mile Place, Lexington.

The fair, sponsored by the University of Kentucky's Sanders-Brown Center on Aging, will run from 10 a.m. to 2 p.m. Its focus of this year is proper nutrition for a healthy brain, providing information on how diet can help promote healthy brain aging and prevent age-related brain disease.

In addition to Michel's free "brain healthy" food, the event will also feature interactive exhibits, health and memory screenings, and presentations about healthy brain aging, Alzheimer's and music therapy.

The event is free and open to the public. For more information contact Sarah Tarrant at (859) 323-1331.

Survey finds 1 in 7 Kentuckians over 44 say they have worsening confusion or memory loss; few say they get needed help

Worsening memory loss reported by Kentuckians in a survey could be indicative of a future Alzheimer's or dementia public health crisis, according to a press release from the Alzheimer's Association.

A first-time survey about memory loss shows that 14.1 percent of Kentuckians aged 45 and older report that they have confusion or memory loss that has become more frequent or gotten worse over the last 12 months. In the 21 states that participated in the study, the average was 12.5 percent.

The survey indicated a gap between need and care. Nearly 61 percent of Kentuckians who reported worsening memory problems said  they need assistance, but only 10.3 percent report getting help. And 25 percent of Kentuckians who reported worsening memory loss live alone.

“The data are indicative of a public-health crisis coming to our region,” Teri Shirk, executive director of the Alzheimer’s Association of Greater Kentucky and Southern Indiana, said in the release.

The report was compiled from data gathered for the first time in the Cognitive Decline Module, part of the Behavioral Risk Factor Surveillance System of the federal Centers for Disease Control and Prevention, in 2012.

Of those Kentuckians who reported memory loss in the survey, 75 percent of them haven't talked to their doctor about it. This is a problem, Shirk said in the release.

"Although the data do not indicate the respondents are cognitively impaired, worsening memory problems are often one of the first warning signs of Alzheimer’s or another dementia," she said.

The Alzheimer’s Association estimates that 67,000 Kentuckians have the disease and estimates this number will climb to 86,000 by 2025.

Of those Kentuckians who reported memory loss, 47 percent said it had interfered with household activities, work or social activities, compared to 40 percent of respondents across the 21 states.

"More than 80 percent have at least one other chronic condition, and many – especially in Kentucky – report conditions or behaviors that we know correlate with Alzheimer’s,” Shirk said. For example, more than 31 percent of Kentucky survey respondents reporting memory issues are smokers, and more than 61 percent say they are in fair or poor health, according to the survey.

“Dementia is absolutely not a normal part of aging,” said Shirk. “And worsening memory loss or confusion does not necessarily mean you have Alzheimer’s disease. If the issue is caused by medication, head trauma or other factors, it may be reversible. But if you do have Alzheimer’s, finding out early means you may be able to begin medications that tend to be more effective in the early stages, and it also gives you the opportunity to participate in planning for your future with the disease … where you will live, how your funds will be used and who will care for you as the disease progresses.”

For more information about the Alzheimer's Association, click here. For more information about the annual fundraising Walks to End Alzheimer's, held in September and October each year, click here.

UK team gets $1.5 million NIH grant to continue success with cell-level study of Alzheimer's disease factor

University of Kentucky researchers have provided the first direct evidence that activated astrocytes could play a harmful role in Alzheimer's disease.

A UK news release explains, "The astrocyte is a very abundant non-neuronal cell type that performs absolutely critical functions for maintaining healthy nervous tissue. However, in neurodegenerative diseases, like Alzheimer’s disease, many astrocytes exhibit clear physical changes often referred to as 'astrocyte activation.' The appearance of activated astrocytes at very early stages of Alzheimer's has led to the idea that astrocytes contribute to the emergence and/or maintenance of other pathological markers of the disease."

UK researchers gave mice gene therapy at a very young age and assessed them 10 months later. The astrocyte activation improved brain function and preserved cognitive function. The research, published recently in the Journal of Neuroscience, has led to a five-year, $1.5 million National Institutes of Health funding grant to the researchers and the UK Sanders-Brown Center on Aging to further this line of study. Chris Norris, an associate professor in the UK College of Medicine Department of Molecular and Biomedical Pharmacology, is the senior author of the study. (Read more)
 

More bad news about childhood obesity: Study finds it can change some kids' brains and damage their mental 'flexibility'

It's not news that Kentucky is lagging in child fitness. In fact, the Truth for America's Health "F as in Fat" report found that the state has the third highest childhood obesity rate in the country. This is bad news, alright, and it's about to get worse. Dr. Claire McCarthy writes in The Boston Globe that a new study in the current issue of Pediatrics and shows that obesity can hurt kids' brains.

"Researchers looked at 49 adolescents with metabolic syndrome. Metabolic syndrome, a consequence of obesity, is the triad of insulin resistance (pre-diabetes or diabetes), high blood pressure and high blood lipids," McCarthy writes. "The researchers compared the adolescents with 62 adolescents who had the same socioeconomic background but didn't have metabolic syndrome. The kids with metabolic syndrome had more trouble with arithmetic, spelling, attention and mental 'flexibility' than the ones who didn't have metabolic syndrome. Even more frightening, the researchers saw actual changes in their brains, in the hippocampus (which plays a crucial role in memory) and the white matter (which passes messages through the brain). It was only a small study, and not all kids with obesity have metabolic syndrome. But this study is alarming -- especially since we don't know if losing weight can make the brain go back to normal."

In her column tagged "MD Mama," McCarthy goes on: "Given that brains are still developing in adolescence, it's very possible that the changes could be permanent. What else do we need before we take the problem of childhood obesity really seriously?" (Read more) To read the study in Pedatrics, go here.

Doctors use telemedicine to help patients with dementia, Alzheimer's

Following a nationwide trend, Kentucky doctors are turning to telemedicine to help patients with memory problems such as those associated with Alzheimer's disease and dementia, reports Allison Elliott with the University of Kentucky.

"State-of-the-art memory evaluations should not be limited to persons that are able tom ake the often long and arduous trip to Lexington," said Dr. Greg Jicha, neurologist at UK's Sanders-Brown Center on Aging. "Taking advantage of Internet technologists to bring expert care into even the smallest of rural communities is a blessing for many families across Kentucky that simply cannot bring a loved one with dementia to Lexington.

Several times a month, physicians with the Sanders-Brown Center will connect to patients in clinics throughout the state. Participating clinics include Harlan Appalachian Regional Health; the Hazard Center for Rural Health; T.J. Sampson Hospital in Glasgow; Trover Clinic in Madisonville; Western Baptist Hospital in Paducah; Owensboro Medical Center; and St. Claire Regional Medical Center in Morehead. (Read more)