Blood test can tell if you're at risk of severe Alzheimer's
A simple blood test can tell which patients will rapidly develop severe Alzheimer's, a new study has revealed.
Identifying those with mild cognitive impairment who are most likely to suffer an accelerated decline could allow them to enter clinical trials and get extra support, researchers say.
Neurologists tested 315 non-diabetic patients with cognitive deficits, including 200 with Alzheimer's disease, for resistance to insulin – a hormone that regulates blood-sugar levels. A simple blood test can tell which patients will rapidly develop severe Alzheimer's, a new study has revealed. Pic: Getty Images
This was assessed using the triglyceride-glucose (TYG) index.
Among those with mild cognitive impairment due to Alzheimer's, individuals with the highest TYG scores declined four times faster over the three-year follow-up period than those with lower TYG levels.
Researchers suggest that insulin resistance, which has been linked to the onset of Alzheimer's, may accelerate progression by impairing the uptake of glucose in the brain, promoting inflammation and disrupting the blood-brain barrier. It may also contribute to the build-up of amyloid, a toxic protein, in the brains of Alzheimer's patients. Identifying those with mild cognitive impairment who are most likely to suffer an accelerated decline could allow them to enter clinical trials and get extra support, researchers say. Pic: Shutterstock
The scientists at the University of Brescia, Italy, also found that high TYG was associated with blood-brain barrier disruption and cardiovascular risk factors.
However, they found no link between high TYG and other neurodegenerative diseases.
Lead researcher Dr Bianca Gumina said: 'Once mild cognitive impairment is diagnosed, families always ask how fast it will progress.
'Our data shows that a simple metabolic marker available in every hospital laboratory can help identify more vulnerable subjects who may be suitable candidates for targeted therapy or specific intervention strategies.' Neurologists tested 315 non-diabetic patients with cognitive deficits, including 200 with Alzheimer's disease, for resistance to insulin – a hormone that regulates blood-sugar levels. Pic: Shutterstock
While insulin resistance has been linked to the onset of Alzheimer's disease, its role in how quickly the condition progresses has received less attention.
This study aimed to fill that gap by focusing on its impact during the prodromal mild cognitive impairment (MCI) stage, when patients follow highly variable trajectories.
Dr Gumina commented: 'We were surprised to see the effect only in the Alzheimer's spectrum and not in other neurodegenerative diseases.
'It suggests a disease-specific vulnerability to metabolic stress during the prodromal window, when interventions may still change the trajectory.'
The researchers found that high TYG was also associated with blood-brain barrier disruption and cardiovascular risk factors. The researchers found that high TYG was associated with blood-brain barrier disruption and cardiovascular risk factors. Pic: Getty Images
However, it showed no interaction with the APOE genotype, a genetic vulnerability that increases the carrier's risk of developing Alzheimer's.
This indicates metabolic and genetic risks may act through distinct pathways, they said.
Identifying high-TYG patients could refine enrolment for clinical trials and prompt earlier lifestyle or drug-based measures to improve insulin sensitivity.
The researchers are currently investigating whether TYG levels also align with neuroimaging biomarkers to aid earlier detection.
'If targeting metabolism can delay progression, we will have a readily modifiable target that works alongside emerging disease-modifying drugs', concluded Dr Gumina.
The study will be presented today at the European Academy of Neurology Congress in Helsinki, Finland.
There are over 64,000 people in this country living with dementia, according to the Alzheimer Society of Ireland, and this number is projected to more than double to over 150,000 by 2045.
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