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A large global study provides new evidence supporting the use of blood biomarkers in an Alzheimer's clinical trial to screen for elevated brain amyloid levels among potential participants who are cognitively unimpaired. The findings, published in JAMA Neurology, show that the relationship between blood biomarker levels and brain amyloid was largely similar across racial groups.
The study also revealed that levels of the biomarker were generally lower among Asian and Black participants compared with white participants, and among Hispanic participants compared with non-Hispanic participants. These differences raise questions about the factors that influence blood biomarker levels and how they relate to dementia risk across populations.
Treatments such as lecanemab can slow cognitive decline in people with early symptomatic Alzheimer's disease by targeting amyloid buildup in the brain. Clinical trials are now testing whether these drugs can delay cognitive decline in cognitively unimpaired individuals with elevated amyloid if taken before symptoms begin.
To help identify participants for these trials, researchers use a blood test that measures the proportion of a protein fragment carrying a specific Alzheimer's-related modification, known as %p-tau217. The blood test helps identify individuals who are more likely to have elevated brain amyloid, which is then confirmed in the study with a positron emission tomography (PET) scan.
Because people from some populations have been historically underrepresented in these trials, researchers have sought to better understand how blood biomarkers relate to brain amyloid across different groups.
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