Comorbid risk factors play vital key to blood-based dementia diagnosis

More than one million cases of dementia are projected by 2056, driving an urgent need to develop an accurate, clinically compliant and cost-effective early diagnosis of this debilitating disease. 

For four years Associate Professor Veer Gupta, head of the Neurodegeneration and Biomarkers group at the School of Medicine, has been the leading IMPACT’s research into using blood as a reliable source when searching for Alzheimer’s disease (AD) relevant biomarkers. 

In 2021, her team focused its efforts on biomarker-based screening of preclinical AD and early cognitive impairment by leveraging the metabolic changes in comorbid risk factors associated with cognitive impairment and/or dementia. 

Assoc. Prof. Gupta says given the likelihood of dementia is associated with several risk factors, an understanding of how an assemblage of risk factors affect an individual’s biomarker profile is critical for developing an accurate diagnostic strategy. Risk factors include retinal degeneration, depression and bone loss. 

The research team’s goal is to leverage the metabolic changes in risk factors associated with cognitive impairment, to develop a blood-based test for early diagnosis of dementia. 

‘Our work focused on developing a blood-based test for early diagnosis of AD/dementia and evaluate the therapeutic potential of novel phytochemicals for treatment of AD,’ Assoc. Prof. Gupta says. 

‘We measured specific biomarkers in blood samples from three longitudinal studies, Optic Nerve Decline and Cognitive Change study (ONDCC), Sydney Memory and Ageing Study (Sydney MAS) and Geelong Osteoporosis Study (GOS), using targeted mass spectrometry, to assess the association of retinal degeneration, depression and bone loss with cognitive decline, respectively.  

‘Preliminary analysis revealed significant association of retinal degeneration, depression and bone loss with the risk of cognitive decline. In addition, we explored the therapeutic potential of phytochemicals in alleviating early metabolic perturbations induced by amyloid beta (Aβ) – the key protein involved in AD pathogenesis.’ 

The work also discovered that the biomarker neurofilament light helps to identify individuals with preclinical Alzheimer’s disease and those likely to progress to a state of cognitive impairment. 

‘Our preliminary results indicate that metabolic changes corresponding to retinal degeneration, depression and bone loss are associated with the risk of cognitive decline,’ Assoc. Prof. Gupta says.  

‘Specific blood-based biomarkers associated with metabolic perturbations relevant to these risk factors will help us to develop a diagnostic model that will enable early diagnosis of AD/dementia with a high accuracy.’ 

Assoc. Prof. Gupta says the research demonstrates that an accurate, cost effective and clinically compliant, early diagnosis of dementia is possible by measurement of biomarkers associated with risk factors and subsequently by integrating the biomarkers to develop a diagnostic model. 

‘Given the increasing ageing population, and the expected increase in dementia cases to 318 per day by 2025, there will be a colossal demand for diagnosis in the future, which will overwhelm the Australian health care system,’ she says.  

‘Being simple and readily available, blood-based diagnosis will averse this pressure and meet the increasing demand. Moreover, being cost effective, people will not have to delay the diagnosis due to an absence of health insurance coverage and limited finances.’

This piece is a real-world impact  article that was recently published in our Annual Report. Interested? Read the full report  here