Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, August 2, 2024

Midlife Blood Biomarkers Predict Late-Life Dementia

 Your competent? doctor should give you this test because of your risk of dementia poat stroke and to initiate those EXACT DEMETIA PREVENTION PROTOCOLS they haven't been working on. You're screwed because of their incompetence!

Your chances of getting dementia. YOUR DOCTOR IS RESPONSIBLE FOR PREVENTING THIS!

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018 

The latest here:

Midlife Blood Biomarkers Predict Late-Life Dementia

Study provides clues that one day, we could detect who's at risk decades in advance

PHILADELPHIA -- Blood biomarkers specific to Alzheimer's disease -- specifically, amyloid-beta 42/40 ratios and measures of phosphorylated tau 181 (p-tau181) -- had a relationship with subsequent dementia that started in midlife, a retrospective analysis showed.

These midlife biomarkers demonstrated long-term associations with late-life amyloid positivity and dementia diagnoses, reported Priya Palta, PhD, MHS, of the UNC School of Medicine in Chapel Hill, in a session presented at the Alzheimer's Association International Conference.

Dementia risk rose with each standard deviation (SD) change in midlife plasma amyloid-beta 42/40 ratio (HR 1.11, 95% CI 1.02-1.21) and in midlife plasma p-tau181 (HR 1.15, 95% CI 1.06-1.25), Palta and co-authors reported in a corresponding paper published in JAMA.

Late-life levels of amyloid, tau, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) also were associated with dementia. NfL is a measure of neuronal injury; GFAP reflects astrogliosis.

"This is a very important data set where they followed individuals, including a large proportion of African American individuals, over a number of decades," noted Stephen Salloway, MD, MS, of Brown University in Providence, Rhode Island, who led an editorial accompanying the JAMA paper.

The findings mean that "as we move earlier in detection and earlier in preventive and risk reduction strategy, I see us eventually being able to detect who's at risk for Alzheimer's disease many years -- decades really, in midlife -- before the onset of symptoms, and then being able to institute either risk reduction and or biological treatments that modify that risk," Salloway said in a JAMA podcast.

"We can't take these results directly now into testing people at midlife with large-scale screening," Salloway pointed out.

But the study "gives us a clue that we will be able to, as our precision increases and the sensitivity of our measures improves, so we can tell who's on the pathway to developing Alzheimer's disease many years before there's any impairment," he said. "That's really exciting. It's a little bit futuristic, but really exciting."

Palta and co-authors used data from the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), a study that recruited a diverse group of middle-aged adults in the late 1980s.

They analyzed data from 1,525 ARIC-NCS participants retrospectively. Blood biomarker data were collected at both midlife (mean age 58) and late-life (mean age 76) periods. Links between blood biomarkers and incident all-cause dementia were evaluated in a subpopulation of 1,339 participants who were dementia-free in 2011-2013 and had biomarker measurements in 1993-1995 and 2011-2013.

Overall, women made up 59.9% of the study population; Black participants made up 25.8%. Dementia was ascertained through neuropsychological assessments, participant or informant contacts, and medical record surveillance. Overall, 252 participants (16.5%) developed dementia in late life.

Decreasing amyloid-beta 42/40 ratios and increasing p-tau181, NfL, and GFAP were seen from midlife to late life, all indicating greater Alzheimer's pathology with aging. Biomarker changes occurred more rapidly in people who carried an APOE4 allele.

Midlife hypertension was associated with a 0.15-SD faster increase in NfL and a 0.08-SD faster increase in GFAP per decade. Midlife diabetes was tied to a 0.11-SD faster NfL increase and a 0.15-SD faster GFAP increase.

Only amyloid and tau biomarkers in midlife demonstrated long-term relationships with dementia. All biomarkers in late life, however, had statistically significant associations with late-life dementia. Plasma NfL had the strongest association (HR 1.92, 95% CI 1.72-2.14).

"There is a shortage of research on blood biomarker changes in individuals in their mid- to late-life, especially in diverse community-based cohorts, and on the relationships between biomarker changes and midlife cardiometabolic disorders," Palta said.

"Understanding these biomarker relationships could provide us further insights into how we can help maintain brain function in people at risk for dementia, monitor disease progression, or identify individuals who may benefit from treatment," she added.

The study had several limitations, the researchers noted. Plasma biomarkers were measured at three time points at most. Only modest associations between p-tau181 and incident dementia were observed in this study; other p-tau assays, like p-tau217, may produce better results.

  • Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow

Disclosures

The Atherosclerosis Risk in Communities (ARIC) study is carried out by NIH grants. The blood biomarker measurements were in part supported by grants by the National Institute on Aging (NIA).

Palta was supported in part by NIA grants.

Salloway reported multiple relationships with industry.

Primary Source

JAMA

Source Reference: Lu Y, et al "Changes in Alzheimer disease blood biomarkers and associations with incident all-cause dementia." JAMA 2024; DOI: 10.1001/jama.2024.6619.

Secondary Source

JAMA

Source Reference: Salloway S, et al "Are blood tests for Alzheimer disease ready for prime time?" JAMA 2024; DOI: 10.1001/jama.2024.12814.

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