In a scientific evaluate of 13 research involving 3 blood biomarkers the paper signifies how diagnostic blood exams may be impactful in real-world settings, notably in international locations which have fewer well being amenities. Revealed within the Journal of Alzheimer’s Illness, and lead authored by Shivani Suresh, the analysis notes that diagnostic blood exams are extra scalable than PET and CSF, and will considerably enhance entry to biomarker-supported diagnoses. Elevated accessibility can ‘democratise’ prognosis as it’s extra simply deployed in Decrease- and Center-income international locations the place at the moment 60% of individuals with dementia stay.
Gold normal diagnostic strategies
To this point, the gold normal for dementia prognosis has been both a PET scan or cerebrospinal fluid (CSF) lumbar puncture. These procedures are more likely to be accessible in larger revenue international locations.
The event of extremely delicate blood-based exams to detect and diagnose Alzheimer’s presents a extremely resource-efficient, non-invasive and accessible various to those dearer and non-scalable strategies.
It’s anticipated that blood biomarkers will obtain regulatory approval within the close to future and business plasma biomarker exams are going to play an growing position in medical companies, given the arrival of illness modifying therapies evidenced by medication like lecanemab and aducanumab.
Biomarkers chosen for comparability
In a paper printed in February 2026, Shivani Suresh describes taking a look at 3 blood biomarkers which have been highlighted as clinically related by the Nationwide Institute on Ageing and the Alzheimer’s Affiliation, synthesising 13 research between January 2019 and January 2025.
- pTau217 is a biomarker related to AD
- glial fibrillary acidic protein (GFAP)
- neurofilament gentle chain (NfL) – NfL is a non-specific biomarker of neurodegeneration, particularly in issues of cognitive dysfunction.
The examine solely checked out knowledge from reminiscence clinics, neurology departments, or medical cohorts – as they signify real-world healthcare companies and clinically consultant affected person teams.
Examine Outcomes
Of the three studied, pTau217 reveals persistently excessive accuracy (AUC > 0.90) throughout all research for Alzheimer’s illness and promise for prognosis of AD.
GFAP and NfL each displayed inconsistent outcomes, however could present complementary info, notably for differential prognosis of each cognitive impairment and different dementias.
NfL is a non-specific biomarker of neurodegeneration, particularly in issues of cognitive dysfunction. Two impartial evaluations of NfL reported average diagnostic accuracy and every demonstrated that the diagnostic efficiency of plasma NfL was equal to its CSF counterpart, suggesting elevated medical utility and scalability.
Though GFAP typically confirmed excessive accuracy in particular comparisons, resembling towards amyotrophic lateral sclerosis and spinocerebellar ataxia, its total diagnostic efficiency was variable.
Eleven out of the chosen 13 research reported each diagnostic (Alzheimer’s versus cognitively unimpaired (CU)) and differential diagnostic (Alzheimer’s versus different neurodegenerative ailments) comparisons. Two research reported differential prognosis alone.
Of the three biomarkers of curiosity, solely pTau217 persistently had an accuracy of >0.90 throughout all research, and all twelve diagnostic comparisons. Though GFAP typically confirmed stronger diagnostic efficiency than NfL, particularly in distinguishing Alzheimer’s from different dementias, the efficiency of each these biomarkers was average and various. Of the thirty diagnostic comparisons by which GFAP was evaluated, six had an AUC > 0.90, sixteen had an AUC >0.75–0.90, and eight reported AUC < 0.75. Twenty-four comparisons had been investigated for NfL, of which just one had an AUC > 0.90.
Want for extra inclusive research to account for inhabitants variety
There may be, typically, a must standardise knowledge reporting and to make research extra consultant of various populations. Solely 2 of the 13 research reviewed included Asian populations.
There’s a clear paradox within the proof in most analysis: validation research for blood-based biomarkers are concentrated in high-income settings, but the best profit for low value and scalable diagnostics is world, notably the place entry to PET and CSF is restricted. In different phrases, in low- and middle-income settings. So, proof isn’t truly being totally examined in real-world settings.
For the long run, the subsequent steps in evaluating blood biomarkers in real-world settings wants to incorporate standards resembling ethnicity, gender, and academic ranges in each LMICs and HICs.
Additional standardized research in underrepresented populations are required to validate and allow blood biomarker implementation in real-world medical settings.
Initially printed on the Dementias Platform UK web site.