Research
Blood test for early detection of Alzheimer’s launched to public
A simple blood test that can detect and screen with 96% accuracy whether a person has Alzheimer’s disease up to a decade before symptoms appear, has been made available to the general public for the first time.
The blood test developed by an international research team led by scientists from the Hong Kong University of Science and Technology (HKUST), could be a potential game changer in the battle to catch and treat the neurodegenerative disease in its early stages.
The PlasmarkAD Blood Test Service is currently only available to patients in Hong Kong at a cost of HK$7,000 (£693 or $894 US).
But Dr Joyce Ouyang, managing director of Hong Kong-based Cognitact, which has licensed the medical breakthrough, has told Agetech World that its rollout in the Chinese city-state potentially paves the way for a cheap and easy diagnosis of Alzheimer’s, that could eventually help millions of people across the globe begin early treatment for the devastating disease.
She said: “It was easier for us to launch in Hong Kong because we are based here, and because of the regulatory framework, but we do plan to extend this to other parts of the world. We need to see how it goes in Hong Kong first, but we do have plans for further commercialisation.
“We think we will seek the possibility of whether it could expand into the UK or Europe through our connections there.”
It is hoped that ultimately the blood test could open the door to novel therapeutic treatments for Alzheimer’s and perhaps be adapted to help detect other neurodegenerative diseases, as Dr Ouyang explained. “The next step is to see if the test can be used for other types of dementia, like frontal FTD (frontotemporal dementia). That would be the first priority.
Dr Joyce Ouyang, managing director of Hong Kong-based Cognitact
“Currently we are using a quite expensive method, that is why our current test is not cheap. But, of course, it is cheaper than other conventional, traditional methods. We do need to do some more research and development, however, to develop some other cheaper methods for the blood test diagnosis.
“Why it is expensive is because we are using a quite costly platform. We are measuring something from the blood to reflect what is happening in the brain, so sometimes these protein levels in the blood are quite low, so that is why we need to use an expensive method to achieve the ultra sensitive detection of those protein levels.
“The plan is to develop a cheaper method to achieve the sensitive detection of those biomarkers. We hope that this can be faster, and in this we are collaborating with other companies to focus on the biotech for the protein part to see whether we can figure out another method to achieve the ultra-sensitive detection and also more cheaply.
“We hope that this will facilitate the test to go further and quicker and cheaper.”
The PlasmarkAD test has taken around five years to develop in collaboration with scientists from University College London (UCL) and clinicians in Hong Kong hospitals, including the Prince of Wales and Queen Elizabeth, with the researchers using Chinese patient data to progress it.
The blood test is aimed at those who are concerned about developing Alzheimer’s. Individuals book an appointment online and do the test at designated centres.
It uses a single drop of blood to determine if a person has Alzheimer’s disease, which affects around 55 million people globally.
In Europe alone, the number of people with dementia – of which Alzheimer’s disease is the most common type – is expected to almost double by 2050, increasing to more than 14 million in the EU and nearly 19 million in the wider region.
Early detection of the progressive disease which damages the brain and often begins with mild memory loss, is key to slowing its effects.
There is currently no cure with an average life span for patients of 10 years post-diagnosis.
Given the devastating effects of the disease and how common it is becoming, the need for more diagnostic tools that can pick up on its presence early and hopefully help slow cognitive decline, has become a scientific cause célèbre.
Currently, Alzheimer’s is typically diagnosed via neuroimaging and analysis of cerebrospinal fluid collected via a lumbar puncture.
But a lumbar puncture can be invasive and painful and brain scans expensive with potentially long waits to both get an appointment and the results.
A blood test for detecting Alzheimer’s disease with 96% accuracy has become available to the public in Hong Kong.
The HKUST blood test leverages world-leading proteomic technology (the systematic analysis of proteins) and self-developed machine learning algorithms. Using this method, PlasmarkAD can detect the level changes of blood biomarkers simply through regular blood draws, and accurately evaluate the instant probability of a person developing Alzheimer’s disease.
Dr Ouyang received her bachelor’s degree at Nanjing University and her PhD from HKUST after which she continued her neuroscience research in Hong Kong for neurodegenerative diseases. Her own research focuses on elucidating the molecular mechanisms underlying Alzheimer’s disease pathogenesis and has identified multiple therapeutic targets for neurodegenerative disease.
She joined Cognitact with a vision of translating the biomarker research into real applications that can be used by the public.
Dr Ouyang said the team at HKUST has identified 19 out of the 429 plasma proteins associated with Alzheimer’s to form the biomarker panel representative of an “AD signature” in the blood.
She explained that based on this panel, the team has developed a scoring system that distinguishes Alzheimer’s patients from healthy people with more than 96% accuracy. This system can also differentiate early, intermediate and late stages of Alzheimer’s and be used to monitor the progression of the disease.
Most notably, this blood test can detect the presence of Alzheimer’s disease five to 10 years before symptoms appear.
Moreover, through multi-dimensional analysis of the human body systems based on the detected protein levels, Dr Ouyang said it can evaluate the status of those areas that may be affected in Alzheimer’s disease, including immune, metabolic, nervous and vascular processes, potentially providing more personalised analysis and treatments.
Dr Ouyang said early detection of Alzheimer’s is critical given that treating it remains a challenge. Patients are only diagnosed when symptoms, such as memory loss, appear. But the actual onset of the disease can be many years earlier.
“The blood test, as you know, the accuracy to detect AD indications is 96% and we can also achieve early screening and early detection of this group of people. The current clinical diagnosis is really too late, when the patient develops the symptoms. The early detection of the disease will help them to save some time. You will have the early intervention of the disease and hope that it will facilitate a cure.
This microfluidic chip will be used to perform protein biomarker measurement, which allows high-throughput sampling and ultrasensitive detection.
“It can assist the longitudinal monitoring of the disease as well. It means that if a patient has already developed AD, our blood test solution can help to evaluate the disease status and also as a way to evaluate if the treatment is having some effect on the disease, delaying the disease, or inhibiting the disease progression as well.
“So we think that our blood test solution is really helpful in the early detection, and also supports and facilitates the early disease management for patients.”
The research facility that has developed the blood test was set up by HKUST in 2020. It received HK$500m worth of government funding. Aside from the blood test, Dr Ouyang said the team is also looking at developing new genome-editing technology treatments for Alzheimer’s.
The work is helping push Hong Kong to the forefront of neurodegenerative disease research.
Current Alzheimer’s disease treatment relies on six existing drugs approved by the US Food and Drug Administration. But Dr Ouyang said they have their limitations.
“There are six drugs launched at the US FDA market for AD cure and five of them actually for the symptomatic relief only, such as the psychiatric symptoms or to reduce stress. They are not curing the disease.
“The last one is a monochloride antibody targeted AD drug launched onto the market in 2021, but because the side effects were quite severe it was withdrawn and then the same company launched another product with an enhanced efficacy.
“Of course, we hope that it can really help to treat AD, but the thinking within the team is that the disease may be diagnosed very late because when the patient really encounters the memory problem, actually the disease is already severe.
“These pathological changes in the brain are irreversible, so that is why the cure for AD does not have that much good efficacy.
“So, we hope this blood test will not only support early detection, but that through this early detection we can identify these group of people and give them early treatment so this can help them suffer less and give them a better quality of life.”
Dr Ouyang said she is confident the HKUST team will continue to play a leading role in advancing research into Alzheimer’s and neurodegenerative diseases, “to move on the development of precision diagnosis and medicine that will benefit people across the world.”
NICE will review whether new Alzheimer’s drugs should be offered on the NHS after an appeal found their wider impact was not fully counted.
An appeal found that the National Institute for Health and Care Excellence had failed to properly account for the wider impact of the treatments, including the heavy burden on unpaid carers, when calculating the cost effectiveness of the medicines.
Both treatments, lecanemab and donanemab, will now return to a NICE committee for further consideration.
“Today’s ruling is an opportunity for NICE to consider the real cost of Alzheimer’s on people and their families, and we welcome the decision to look again at whether new medicines could be provided on the NHS,” said David Thomas, head of policy and public affairs at Alzheimer’s Research UK.
Lecanemab and donanemab do not cure Alzheimer’s, but they slow it by targeting and clearing clumps of amyloid proteins, sticky protein build-ups in the brain linked to the disease.
While the drugs are available privately in the UK for people who can afford them, NICE ruled last year that they were too expensive to be made available on the NHS in England and Wales.
It is estimated informal dementia care costs the economy more than £20bn a year.
Alzheimer’s Research UK wants NICE to update how it assesses the value of new dementia drugs and factor in the huge additional costs this condition places on society and the wider economy.
NICE and its expert committees assess whether new drugs are good value for money for the NHS based on a wide range of evidence.
This includes how treatments perform in clinical trials, the experiences of patients and carers, and the costs of new drugs as well as any changes to NHS services needed to provide access.
When NICE weighs up whether a new Alzheimer’s drug is cost effective for the NHS, it carries out a limited assessment of the impact dementia has on the health of carers.
But the condition takes an enormous toll on families and society because caring for someone with dementia can lead people to become more isolated and give up work.
It can have a major emotional impact and put families under financial strain.
Thomas said: “Research has delivered new treatments with the potential to provide people with valuable extra months of independence, lessening the burden on carers.
“While these treatments offer modest benefits and can cause serious side effects, they provide the foundation for a future where dementia becomes a treatable condition.
“Now we need NICE to look again at how these medicines could benefit both people with early Alzheimer’s and their carers.”
Chris, whose mother Shirley is living with Alzheimer’s disease, said: “The real cost of Alzheimer’s is far greater than many people realise.
“In order to give my mum the care she needed, I moved back home to help my dad as the care was too much for him alone. After my dad passed away from Covid in 2021, I became sole carer for my mum.
“It was a very difficult period, working a full-time job, caring for Mum and dealing with the loss of my dad. Eventually I got some in-home care support to help.
“The family has borne most of the cost of Mum’s care, both in time and fees, and the family home has been sold to finance it.”
“The emotional and financial strain Alzheimer’s has taken on our family is horrendous, and I know many families across the UK are experiencing this pressure.”
He is backing Alzheimer’s Research UK’s call for NICE to change how it evaluates new dementia treatments.
The timeframe for the next NICE meetings to discuss the drugs is still to be set, and it is not certain follow-up hearings would change NICE’s guidance on access to the medicines.
But Alzheimer’s Research UK is continuing to push to make sure dementia is now a main priority for political and NHS decision-makers.
The head of the ongoing independent review into adult social care, Baroness Louise Casey, has called on the government to act, show leadership and prioritise dementia.
She has proposed appointing a dementia tsar to drive forward the prevention, treatment and care of dementia.
Baroness Casey has also argued for more funding for dementia treatment trials.
With more than 130 Alzheimer’s drugs in clinical trials worldwide, the charity says it is vital the NHS runs trials of new treatments now to understand how to deliver them to eligible patients in future.
In addition to changing how NICE assesses new medicines, the health service needs to collect real-world evidence on new dementia drugs and prepare for diagnostic tests and innovative treatments that are coming.
“Alzheimer’s Research UK is calling on the government to give dementia the same political determination that transformed cancer care,” Thomas said.
“We urgently need investment and a clear UK-wide plan so new treatments can be assessed in the NHS and reach the people who stand to benefit.”
Health and social care secretary Wes Streeting has said dementia is “one of the greatest challenges of our time” and pledged that the UK should become a world leader in dementia clinical trials.
Osteoporosis drugs may lower dementia risk, with a study suggesting one widely used treatment could help prevent Alzheimer’s and related dementias.
The research found that nitrogen-containing bisphosphonates, drugs widely used to treat osteoporosis, may significantly reduce the risk of Alzheimer’s disease and related dementias in older adults with osteoporosis or fragility fractures.
Osteoporosis and dementia often coexist in older adults and share several risk factors, including advanced age, female sex and reduced physical activity.
Researchers at the University of Hong Kong’s department of pharmacology and pharmacy carried out a large study using the city’s electronic medical records, covering more than 120,000 patients aged 60 and above with osteoporosis or fragility fractures between 2005 and 2020.
The team found that NBP users had a 16 per cent lower risk of developing Alzheimer’s disease and related dementias than untreated patients, and a 24 per cent lower risk than those who received other osteoporosis medicines.
The association was especially marked in women and patients with hip fractures.
The researchers estimated that treating 48 patients with NBPs for five years could potentially prevent one case of dementia, underlining the possible public health value of NBPs in high-risk groups.
Professor Cheung Ching-lung, associate professor in the department of pharmacology and pharmacy at the University of Hong Kong, said: “Our study provides evidence that NBPs may offer dual benefits in strengthening bones and reducing fracture risk, as well as potentially preventing ADRD.
“Their potential neuroprotective role provides an empirical basis and supports future research on the actual effectiveness of this medication in preventing or delaying cognitive decline associated with ADRD.
“These findings are significant as they demonstrate a potential approach for reducing dementia risk in a vulnerable population using safe and widely available NBPs.
“In our rapidly ageing society, these findings suggest that while waiting for the novel therapies, existing medications can also provide additional protection for high-risk populations.”
The same research team has previously found that osteoporosis and fractures are independent risk factors for dementia, and that patients with dementia are at higher risk of falls and fractures.
This suggests treating osteoporosis may also help reduce the burden of dementia.
NBPs, including alendronate and zoledronate, are well established and commonly prescribed osteoporosis drugs.
Emerging biological research suggests the pathways affected by NBPs may also play a role in the development of Alzheimer’s disease and related dementias, raising the possibility that they could be repurposed for prevention.
A prebiotic fibre supplement may ease arthritis pain and improve grip strength in people with knee osteoarthritis, a study suggests.
The daily supplement, made from inulin, a dietary fibre found in chicory root, Jerusalem artichokes and other vegetables, also lowered pain sensitivity and saw fewer people drop out than a digital physiotherapy programme tested alongside it.
Dr Afroditi Kouraki, lead author of the study from the University of Nottingham, said: ‘Our findings suggest that targeting gut health with a prebiotic supplement is a safe, well-tolerated, and effective way to reduce pain in people with knee osteoarthritis.
“The very low dropout rate compared to the exercise group is also encouraging from a public health perspective, people were able to fit this supplement easily into their daily lives.’
Osteoarthritis of the knee, a wear-and-tear joint condition, affects hundreds of millions of people worldwide and is a leading cause of pain and disability, particularly in older adults.
Current treatments rely heavily on pain medication, which can cause side effects, or exercise programmes, which many patients find hard to maintain.
The INSPIRE trial, led by researchers at the University of Nottingham, involved 117 adults with knee osteoarthritis and tested four groups: inulin alone, digital physiotherapy-supported exercise alone, a combination of both, and a placebo. Both inulin and physiotherapy independently reduced knee pain.
However, inulin alone improved grip strength and reduced pain sensitivity, measures linked to how the nervous system processes pain, while physiotherapy did not.
The dropout rate for those taking the supplement was just 3.6 per cent, compared with 21 per cent for the physiotherapy group, suggesting a daily supplement may be easier for people to stick with than an exercise programme.
Inulin works as a prebiotic, meaning it feeds beneficial bacteria in the gut.
This leads to the production of compounds called short-chain fatty acids, particularly butyrate, which can affect inflammation and pain pathways throughout the body.
Participants taking inulin also showed increased levels of both butyrate and GLP-1, a gut hormone linked to pain regulation and muscle health.
Higher GLP-1 levels were associated with improved grip strength, pointing to a possible gut-muscle connection.
Senior author Professor Ana Valdes added: ‘The link we observed between GLP-1 and grip strength is particularly intriguing and points to a broader gut-muscle-pain axis that warrants further investigation. This could have implications not just for osteoarthritis, but for understanding how gut health influences ageing and physical resilience more broadly.’
Professor Lucy Donaldson, director of research at Arthritis UK, said: “The pain of arthritis can severely impact quality of life. Our recent lived experience survey showed that six in ten people are living in pain most or all of the time due to their arthritis.
“Researchers are starting to explore the role of the gut microbiome in our experience of pain.
“This exciting preliminary research highlights how diet and physiotherapy can act in different ways to have benefits for people with arthritis.
“We know a variety and balance of healthy foods, including fibre, and regular physical activity matter, and we’re glad to be supporting research that explores how they work to help people with arthritis.”
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