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by Dr. Ilene Naomi Rusk
Director of the Healthy Brain Program in Colorado
Alzheimer’s disease affects millions globally, with a significant impact on older adults, particularly women. Diagnosing Alzheimer’s disease and other dementias has always been challenging, as there is no single definitive test. These neurological illnesses that affect people’s memory and other aspects of their thinking are typically identified through a series of assessments, including neuropsychological tests, brain imaging techniques like PET, MRI, and SPECT, possibly a lumbar puncture and a thorough clinical history and examination by a cognitive specialist, like a neurologist or a neuropsychologist. With a growing body of knowledge on preventing and treating, and even possibly reversing dementias like Alzheimer’s, it can be incredibly beneficial to find out if you have biological indicators for these conditions as early in the disease process as possible.
Many people know about the increased risk for late onset Alzheimer’s disease if you have one or two copies of the APOE4 genotype. While knowing your APOE genotype is important, it does not necessarily indicate whether you have an underlying neurological illness or signs of one in your body. Scientists and researchers have been striving to develop simple blood tests that can offer insights into brain health. Early diagnosis and intervention are crucial, as the pathology of Alzheimer’s begins decades before clinical symptoms appear. Sharp Again is dedicated to educating patients about the importance of early detection and has programs with science backed interventions for lifestyle modifications to delay or prevent dementia.
One of the major advancements in Alzheimer’s diagnostics is the development of very sensitive plasma biomarker assays. These are simple blood tests that often do not require fasting or any special preparation. These blood biomarkers can now be determined with a simple blood test. Today, we have blood biomarkers looking at amyloid and tau, among other protein markers, that are elevated in the brains of people with Alzheimer’s. These tests can be obtained through healthcare providers and a consumer facing bundle called BrainScan from Apollo Health. These tests can give you an idea if you are likely to develop a neurological illness like Alzheimer’s. Many of these tests are FDA-approved and covered by insurance.
These blood tests offer a less invasive and more cost-effective alternative to traditional methods like brain imaging PET scans, MRIs, SPECT scans, or lumbar punctures. Plasma biomarkers such as pTau 217, Amyloid 42/40, pTau 181, NfL (neurofilament light chain), GFAP (glial fibrillary acidic protein), and the ApoE4 genotype are vital for detecting and predicting early-stage Alzheimer’s and other dementias, as well as monitoring disease progression. These biomarkers can accurately predict amyloid pathology and provide valuable insights into neuronal damage and inflammation in the brain. GFAP and NfL are important for their roles in indicating ongoing inflammation and damage to axons in the brain, respectively. Even if you have no symptoms, it can indicate years in advance that you are likely to get Alzheimer’s, and we know that Alzheimer’s can be brewing in the brain up to 20 years before first clinical symptoms appear.
A new combination test called Lumipulse G (pTau217/β-Amyloid 42/40 Plasma Ratio) test enhances the diagnostic accuracy of Alzheimer’s disease, and the good news is that it was just approved by the FDA. These biomarkers also offer exciting potential for improving diagnosis, monitoring, and research, and it’s important to use them cautiously and ensure that the patient consents to getting the test and understands the consequences of knowing the outcome. If you are someone willing to take action to prevent dementia if these tests are positive, talk to your integrative medical provider. The biomarkers test should always be done with thorough clinical assessments by a qualified clinician, so that you can discuss making personalized lifestyle and medical decisions together.
Blood biomarkers are hopeful and positive move forward for the early diagnosis of neurodegenerative illnesses like Alzheimer’s disease, with the ability to detect the illness even before there are clinical symptoms. If knowing your biomarkers would help you make brain-healthy changes, consider getting tested, working with your functional medicine or Bredesen trained clinician to target your treatments. We now know that intervening early can be very helpful to slow or even stop disease progression and ultimately contribute to overall brain health and longevity. Staying educated and updated about advancements in these tests can lead to improved outcomes and a deeper understanding of Alzheimer’s pathology and the available treatments. By leveraging these biomarkers, together we can move closer to the goal of helping you prevent and effectively treat Alzheimer’s disease.
Dr. Ilene Naomi Rusk is Director of the Healthy Brain Program in Colorado and is coordinator of the rehabilitation and trauma treatment programs. She has a Ph.D. from the University of Birmingham in England and has authored numerous papers in the areas of psychology, neuropharmacology and neuroscience in areas as diverse as cerebral palsy in children, Parkinson’s disease, Alzheimer’s disease, and the effects of neurotransmitters on behavior. She trained with Dr. Dale Bredesen and the Institute for Functional Medicine in using an integrative approach to working with cognitive decline and dementia prevention. Dr. Rusk thinks this way when she sees her patients. Creating flexibility in the nervous system and incorporating trauma healing strategies form the basis of her resiliency approach to cognitive health and Alzheimer’s treatment. Dr. Rusk utilizes her expertise in her humanitarian work in countries around the world that are affected by disasters and war.
