Blood biomarkers for the identification of Alzheimer's disease (BEAT Alzheimer)

The timely and accurate diagnosis of Alzheimer's disease (AD) in clinical practice remains challenging, even if a public health priority. Among the most used markers for predicting the onset of AD, also in early stages, PET and cerebrospinal fluid biomarkers are the most widely used. Unfortunately, these markers present some important limitations for clinical practice such as high cost, poor accessibility and invasiveness. Therefore, emerging blood-based markers have the potential to be accurate, cost-effective, and easily accessible for widespread clinical use, and could facilitate timely diagnosis of AD. These biomarkers, however, are still poorly used in clinical practice. For better understanding their roles, four national partners, representative of all Italy (i.e., Palermo, Bari, Venice, and Brescia) will be part of this project. The study will have three specific aims. First, to detect if any tool commonly used in daily clinical practice could predict the onset of dementia and in particular of AD. For reaching this aim, we will combine medical, radiological, and other information commonly available in the assessment of dementia, using an artificial intelligence approach for big data. At least 200 patients with AD and non-AD related dementia will be included for reaching this aim. Second, we will be to verify the characteristics in terms of accuracy, robustness and regulation of several biomarkers used for the early detection of dementia in experimental or retrospective studies. For reaching this aim, we will use biobanks already available among the partners and, as biomarkers, blood levels of Aẞ42/40 ratio, p-tau181 and p-tau217, neurofilament light chain (NFL) and glial fibrillary acidic protein (GFAP). At least 500 patients for which complete data regarding blood biomarkers and information regarding their conversion or not from MCI (mild cognitive impairment) to dementia will be used. Finally, we will prospectively combine the information given by blood biomarkers mentioned above and the information given by demographic, neuropsychological tests, and clinical and radiological information available with a standard evaluation for dementia for detecting the transition from MCI to dementia. For reaching this aim, we will enroll 200 older people (age >=60 years) with MCI we will follow them for 24 months, with periodical follow-up of six months, to verify those that will become affected by AD or not. We believe that our project can add important information in terms of the prediction of AD, representing an innovative diagnostic option that could be used in all the ambulatories dedicated to dementia, since blood biomarkers are easily available and are not invasive. Our study will add important information regarding how to early identifying AD and therefore propose interventions tailored for the patients, in order to avoid the transition to AD.