So at the current time, biomarker testing should only be performed in cognitively impaired patients as part of a clinical evaluation. And this is the recommendation of the Alzheimer’s Association clinical practice guidelines. So at this point, we don’t recommend biomarker testing in cognitively unimpaired individuals. Also, we have to think that the biomarker testing is going to help the patient in some way...
So at the current time, biomarker testing should only be performed in cognitively impaired patients as part of a clinical evaluation. And this is the recommendation of the Alzheimer’s Association clinical practice guidelines. So at this point, we don’t recommend biomarker testing in cognitively unimpaired individuals. Also, we have to think that the biomarker testing is going to help the patient in some way. And that may be by providing them with a more accurate diagnosis, which can be useful in care planning. Or increasingly, the results of these biomarker tests can tell us whether patients are eligible for Alzheimer’s disease-specific treatments, like amyloid targeting treatments. So currently, there are many blood tests for Alzheimer’s disease pathology that are available. So there’s P-tau217 tests, P-tau181 tests, Aβ42/40, NFL, GFAP. There’s panels of all of these analytes together. So clinicians who aren’t as familiar with these tests are kind of confused by the long menu and not quite sure what to order. And oftentimes, they find that some of these biomarkers don’t all agree. So, for example, maybe P-tau217 is high, but Aβ42/40 is still in the normal range. So, this really provides a lot of opportunities for confusion when there’s so many choices. And increasingly, what I’ve recommended is that clinicians try to keep it simple and just use P-tau217-based tests because we know that those are the most accurate. And in fact, many of these other analytes actually add very little to no improvement in terms of determining whether someone has Alzheimer’s disease pathology or not. So my general advice is just to use a high-performance P-tau217-based test and to use that to determine whether someone has Alzheimer’s disease pathology or not. These other markers are typically not indicated, and they’re really typically not helpful in most cases.
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