Selective screening for people at risk of Alzheimer’s

A researcher from the Chronic Diseases Research Unit (UFIEC) of the Carlos III Health Institute (ISCIII) has published in Med magazine an article about the early detection of Alzheimer’s disease, in which priority is given, looking to the future biomarker developmentfor screening focused on people at risk of Alzheimer’s.

In this sense, they are betting not on generalized screening, but on focused strategies “in people at high risk, who balance clinical opportunity with ethical responsibility and economic viability”, the published article provides a scientific and ethical framework in the field of possible selective detection in people at risk of suffering from this neurodegenerative disease.

The publication of the article is part of the development of the European consortium CombiDiag MSCA Doctoral Network, which has the participation of the ISCIII and which seeks to promote early diagnosis in Alzheimer’s, develop new diagnostic strategies using peripheral biomarkers little invasive.

The doctor Eva Carrohead of the Alzheimer’s Neurobiology Unit of the UFIEC-ISCIII and part of the Neurodegenerative Diseases Area of ​​the Network Biomedical Research Center (CIBER-ISCIII), explains how in recent years new options are emerging for the possible early detection of Alzheimer’s, in people with symptoms linked to the earliest phases of the disease and even in people who are still asymptomatic.

Without the current possibility of having healing therapies“the recent approval of disease-modifying treatments, and advances in less invasive or non-invasive biomarkers, are changing the paradigm towards early detection,” he explains.

The article, in the form of a Comment and signed with the doctor Fangya Xufrom the University of Reading, in the United Kingdom, presents a multidisciplinary framework that integrates existing scientific evidence, ethical principles and value-based clinical care, as a possible guide to develop and consolidate early detection programs for Alzheimer’s.

The authors explain that it is increasingly feasible to detect Alzheimer’s disease in preclinical or prodromal phases, with tools such as body fluid biomarkers and digital biomarkers, and add that its possible use in more proactive processes early detection must make it clear “on which people to do it and under what conditions, always seeking people’s quality of life and respecting scientific integrity and medical ethics.”

Biological biomarkers and digital tools

In the field of diagnostic blood biomarkers, mention is made of promising areas of study“such as markers linked to amyloid-B (AB) and tau proteins, the relationship between AB42 and AB40 peptides and amyloidosis, phosphorylated tau isoforms and light chain neurofilaments, which can help differentiate early-stage Alzheimer’s from other dementias or from the natural symptoms of aging.”

They are also being studied non-blood markerssuch as immune and inflammatory responses linked to the first symptoms of the disease, biomarkers in saliva, urinary metabolomic profiles and even microRNAs present in tear fluid. Along with these biological biomarkers, there are digital and electrophysiological tools that are emerging as possible non-invasive avenues for the early detection of Alzheimer’s, such as quantitative electroencephalography (QEEG) models and natural language processing (NLP) tools.

The authors point out that integrating data from genetic, metabolic and behavioral signals “may enable the development of adaptive risk algorithms and personalized detection strategies.”