Blood test could speed up Alzheimer's diagnosis

A major new blood test for Alzheimer’s is being trialled in the UK that could revolutionise diagnosis of the deadly condition.

People with suspected dementia are being recruited via NHS memory clinics to check how well the test works. Experts hope to have answers within three years.

The trial forms part of the Blood Biomarker Challenge, a multimillion-pound programme supported by Alzheimer’s Society, Alzheimer’s Research UK and the People’s Postcode Lottery.

A team led by University College London (UCL) is investigating whether the test, which measures the protein p-tau217, can improve the early and accurate diagnosis of Alzheimer’s disease.

The test has already been shown to be effective in looking for the protein but researchers want to know whether giving it to patients near the start of an assessment for memory and thinking problems helps guide diagnosis and treatment.

The study will recruit 1,100 people from diverse geographic, ethnic and economic backgrounds, alongside those living with other health conditions, to ensure the findings are relevant in a wide population.

Analysis suggests the test can tell around 80 per cent of people with cognitive decline whether they are likely to have Alzheimer’s.

Alzheimer’s disease is the most common cause of dementia and linked to the build-up of two key proteins in the brain called amyloid and tau.

P-tau217 is regarded as a promising biomarker that shows both amyloid and tau are present in the brain.

Experts believe blood tests such as plasma p-tau217 can detect these proteins as accurately as current – but more invasive – methods such as PET scans and lumbar punctures.

If shown to work in NHS practice, blood tests could be used as part of a wider assessment to confirm the diagnosis of Alzheimer’s disease for people who already have memory or thinking problems.

The Alzheimer’s Disease Diagnosis and Plasma pTau217 (Adapt) team behind the study is led by Professor Jonathan Schott and Dr Ashvini Keshavan.

Dr Keshavan said on Wednesday it was vital new research helped identify the type of dementia a patient is suffering from.

Comparing dementia diagnosis to cancer, she told the BBC: “We wouldn’t accept not knowing what type of cancer a person has and appropriate treatment.

“Right now that’s the situation in the UK, where most people don’t know what type of dementia they have.”

Professor Schott, from UCL and chief medical officer at Alzheimer’s Research UK, said:

“After decades of research, we now have a blood test for Alzheimer’s disease that is backed by strong scientific evidence and provides comparable information to other gold-standard diagnostic tests yet is far more accessible, and cheaper.

“Currently only about 2 per cent of people diagnosed with Alzheimer’s have access to one of these gold-standard diagnostic tests.

“While identifying Alzheimer’s disease early and accurately is already important for enabling access to current therapies and planning care, it will become even more critical as a new generation of treatments emerge that can slow down the decline of memory and thinking.

“Timely diagnosis will be key to ensuring these advances reach the people who need them most.”

In January, a research team from the University of Oxford and University of Cambridge – also part of the Blood Biomarker Challenge – announced they had begun using a different suite of tests on dementia patients.

This team is assessing multiple new and existing blood tests, looking at a range of dementia types including Alzheimer’s disease, vascular dementia, frontotemporal dementia, and dementia with Lewy bodies.

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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.

Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.

“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.

Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.

“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.

Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.

From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.

Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.

BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.

Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.

Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.

“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.

Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.

“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.

“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”

The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”