Dementia, towards tests to predict it 10 years earlier

The challenge: reading the future in blood. In another study tests to find out who could have a heart attack within 6 months

Predict dementia 10 years in advance or find out who could have a heart attack within 6 months. Reading the future in blood, proteins and metabolites, putting together multiple indicators and mixing them with information on age, sex and more. This is the challenge undertaken by several teams of scientists. With results that seem to open up the application of models capable of predicting imminent diseases and risks. Models from which new tests could arise. Two different studies published in Nature group journals illustrate some possible scenarios: for example that of being able to predict the onset of dementia in healthy adults, even more than 10 years before diagnosis, from the analysis of some proteins in the blood; or even find out who could have a heart attack within 6 months, putting together the ‘alerts’ that can be intercepted by 43 metabolites and 48 proteins with the person’s identikit: age, sex, blood pressure.

The advent of proteomics, explain the authors of the work published in ‘Nature Aging’, i.e. scientists from the Fudan University of Shanghai in China, “offers an unprecedented opportunity to predict the development of dementia. We verified this in the data of 52,645 adults without the pathology, contained in the UK Biobank, with 1,417 cases that occurred over time and a follow-up of 14.1 years. Out of 1,463 plasma proteins, there were some – the researchers observed – that were largely consistently associated with the onset of all-cause dementia, Alzheimer’s disease and vascular dementia.

These proteins (Gfap, Nefl, Gdf15, and Ltbp2) ranked high in order of importance. People with higher GFAP levels were 2.32 times more likely to develop dementia, the authors report. And in particular, Gfap and Ltbp2 were highly specific for predicting dementia. GFAP and NEFL began to change at least 10 years before diagnosis. “Our findings strongly highlight GFAP as an optimal biomarker for predicting dementia, even more than 10 years before diagnosis, with implications for screening people at high risk for dementia and for early intervention.”

The other study, published in ‘Nature Cardiovascular Research, describes the work of an international team of scientists (mostly Swedish, but among the authors there is also an Italian, Giovanna Masala of the Clinical Epidemiology Unit of the Ispro-Institute for study, prevention and the oncology network of Florence). The researchers focused on myocardial infarction, “one of the leading causes of death globally, notoriously difficult to predict. Our goal – they explain – was to identify biomarkers of an imminent first myocardial infarction and design relevant prediction models” .

The researchers looked at 2,018 people without previous cardiovascular disease from 6 European cohorts, among whom 420 developed a first myocardial infarction within 6 months of the baseline blood draw. “We analyzed 817 proteins and 1,025 metabolites in biobanked blood and 16 clinical variables,” the authors illustrate. Result: 48 proteins, 43 metabolites and the variables age, sex and systolic blood pressure were “associated with the risk of an imminent first myocardial infarction”. Brain natriuretic peptide was more consistently associated with the risk of impending myocardial infarction, they found.

Using readily available variables, the authors therefore designed “a prediction model” for impending myocardial infarction “for clinical use in the general population, with good performance” that allows “discrimination” of cases and “potential to motivate prevention efforts”. primary prevention”.