Spinal-Fluid Test Confirmed To Predict Alzheimer's

omnibit writes "The New York Times reports that researchers have found a spinal-fluid test can be 100 percent accurate in identifying patients with significant memory loss who are on their way to developing Alzheimer's disease. The new study included more than 300 patients in their seventies, 114 with normal memories, 200 with memory problems, and 102 with Alzheimer's disease. Their spinal fluid was analyzed for amyloid beta, which forms plaques in the brain, and for tau, another protein that accumulates in dead and dying nerve cells in the brain. Nearly every person with Alzheimer's had the characteristic spinal fluid protein levels."

Comments

Re:Thank goodness:

[Rei]

Yeah... too bad it's a spinal fluid test. Those are nasty. My spouse had one and the hole in the dura refused to close, which is apparently a fairly common side effect. Net result: unbearable, nonstop, over-10-on-a-1-to-10-scale headaches that can't be controlled with headache medicine. Caffeine on an IV drip works, but only temporarily. The headaches lasted for weeks until the doctors finally managed to close the hole with a blood clot. The clot doesn't actually fix the problem, but the dura managed to repair itself while the clot held. I've heard of people, however, who *never* healed from it. What a miserable experience.

100% Accurate, Nearly All of the Time!

[Alphanos]

So, just to clarify, this test "can be 100% accurate", while at the same time "Nearly every person with Alzheimer's had the characteristic spinal fluid protein levels."

That's a pretty neat trick.

Re:100% Accurate, Nearly All of the Time!

[GNUALMAFUERTE]

Yeah, not only that, but also it says that many people without Alzheimer's turned out positive too ... so they assumed those are going to develop Alzheimer's.

It produces false negatives, and it might be producing false-positives, but we won't know until 10 or 20 years later. But it still is 100% accurate. Nice math there. This trend of early publishing non peer reviewed material while making extraordinary claims, only to never hear from it again is starting to get really old.

Re:100% Accurate, Nearly All of the Time!

[timeOday]

Read it again, because there is nothing in the article that contradicts the claim that "researchers have found a spinal-fluid test can be 100 percent accurate in identifying patients with significant memory loss who are on their way to developing Alzheimer's disease.":

"Nearly every person with Alzheimer's had the characteristic spinal fluid protein levels. Nearly three quarters of people with mild cognitive impairment, a memory impediment that can precede Alzheimer's, had Alzheimer's-like spinal fluid proteins. And every one of those patients with the proteins developed Alzheimer's within five years. And about a third of people with normal memories had spinal fluid indicating Alzheimer's. Researchers suspect that those people will develop memory problems. "

However, the test can only be 100% accurate if the spinal fluid proteins that presage Alzheimer's decrease after full onset.

The fact that not everybody who tested positive developed Alzheimer's during the study is no counter-indicator at all, especially if they kept testing new subjects throughout the trial (i.e. some were only tested recently).

Of course, the usual caveats apply - you can't predict with 100% accuracy who will develop Alzheimer's years from now because some will die first of other causes. And in biology (and medicine), even if your test is correct on the first 10 patients, and the first 100, and 1000, you just know some smart-alec is going to buck the trend eventually :) Biology is just too messy to follow any simple rules all the time. But that doesn't necessarily have a whole lot of relevance to clinical applications.

Re:Thank goodness:

[ColdWetDog]

That happens, but it is rare. But because of the potential numbers of people who would want the test, the difficulty of doing a lumbar puncture (spinal tap) on persons who have arthritis in the back (very common among us ancient folk), are of the supersized persuasion, or have other reasons to dissuade themselves, I don't think this is going to be the ultimate test.

Instead it will serve as a proxy to allow simpler tests to be developed. TFA also notes that PET scans are fairly accurate. These are available at many larger medical centers but are also pretty pricey and technically complex.

This is also not the first time that lumbar punctures for beta amyloid have been used to diagnose Alzheimer's. And finally, the abstract of the original article for your viewing pleasure.

Not just a test benefit

[Eccles]

Not only does this give an actual test for Alzheimers, it also means that there's a definitive symptom for it. Wipe out the cause of that symptom and maybe you can stop or reverse the progression of this horrible affliction.

My father is already at the moderate dementia stage of this illness, and it's devastating. Not so much for him as it is for my mother.

Does knowing early help?

[RabbitWho]

There's no treatment for it and nothing they can do. I'd rather not know for as long as possible, you start going crazy as you watch yourself deteriorating every day. If I forget and put door keys in the microwave I think "oh I'm such an idiot." and laugh. I don't feel the terror that someone with Alzheimers feels, thinking every mistake is a sign.

Re:Does knowing early help?

[phantomfive]

Watching my grandpa suffer through Alzheimer's, this is a real issue. At first he took it with a sense of humor, when I called he'd say, "hey, I almost forgot about you! Call more often!" But soon I could see it was really getting to him, and he was starting to withdraw into that stupor that people get into at convalescent homes.

So I forced him to be active; when he tries to tell me something, and can't think of the word, I just wait for him to spit it out, or tell him to explain it a different way. Get him active, help him see that life can be good even though he doesn't remember quite as well. I treat him like a human and make him connect to me like a human. No withdrawing into that shell just because you can't remember well. I took him to see giant trees and waves and stuff. Giant trees and waves always make you feel alive.

So now he is happier, got over his anger streak, and he doesn't worry if he can't remember everything (it doesn't matter if you can find a way to work around it).

Re:Thank goodness:

[Have Brain Will Rent]

Yup my Dad had that done and he said it was the most painful thing he'd ever had happen... and this was a guy who grew up on a farm (a great source of pain), served years in combat during WWII and so on and so, on without ever raising a complaint.

The next time he had to go in was because of a disc problem and they essentially injected his spine with meat tenderizer to dissolve the ruptured disk away. He said compared to the spinal tap that didn't hurt at all (except for the nurse yanking his boxers off without first checking for protrusions - yikes!).

Re:Thank goodness:

[0100010001010011]

Only 100% accurate? Given the necessity for a spinal tap it should go to 110%.

Re:Thank goodness:

[cgenman]

In her early onset of Alzheimer's, I used to say shocking things about my life to my Grandmother. She'd be surprised, righteously indignant, and secretly curious. She'd ask all sorts of questions. Fifteen minutes later, we'd do it all again.

When I left from these visits, she'd be absolutely glowing. She'd be awake, excited, and extremely happy. And she had no idea what happened. Next time in, I could make the shocking revelations again with the same effect.

Re:Thank goodness:

[hey]

If I had points I'd bump you to 6.

Re:Thank goodness:

[electrostatic]

Man visits his doctor.

Man: "What's the news, Doc."

Doc: "Not so good. Test results show cancer, and ... spinal fluid indicates ... Alzheimers."

Man: "... Well, at least I don't have cancer."

From someone that lost his mother to Alzheimer's

[pgmrdlm]

I don't know if this is good or not. Please let me explain.

If you have ever had the misfortune of having a relative with Alzheimer disease, you know they are nothing like the person you loved and cherished. Everything from forgetfulness, to wanderings where you search the streets for them, to the extreme mood swings where they get violent. Its a terrible experience for both you and the people that have this disease.

If you are diagnosed with this disease in advance, and there are no cures? How do you tell your family and friends? What are you going to think about the pain you know that you may be putting them in?

Knowing how my mother became with this disease, if I find out that I have it and there are no cures. I don't want to put my friends and family through the same experience. I would rather drive my car into a wall at 120 miles an hour.

Just my perception, sorry.