Well, biomarkers are fantastic because we are able to see things that in the past we could only do with an autopsy examination, and they really came to stay. But I think we need to understand that even the clinically approved biomarkers, they have their limitations. Of course they are helping, but they are helping with the right questions. So what will be the wrong questions with biomarkers, I think, at this point? We tend to test people in their 60s and 70s...
Well, biomarkers are fantastic because we are able to see things that in the past we could only do with an autopsy examination, and they really came to stay. But I think we need to understand that even the clinically approved biomarkers, they have their limitations. Of course they are helping, but they are helping with the right questions. So what will be the wrong questions with biomarkers, I think, at this point? We tend to test people in their 60s and 70s. And we are learning from post-mortem studies that we can look under the microscope. The frequency, even of Alzheimer’s disease, is not that high. So in every 100 people at the age of 70, about 15 will have enough Alzheimer’s pathology in the brain. It doesn’t mean they have dementia. So because of it, when we don’t have a lot in the population, there is a higher chance that the positive test is not a real positive, it’s a false positive. And this is something you have to keep in mind because now that biomarkers, especially in the blood, are becoming so widely available, even if we recommend that people don’t do it without a doctor asking for it, we know that things work that way, someone who can pay can go to a lab and get tested, and then they will have a result, and they will have to wait months to see a clinician, and they will be very nervous about it, and it can be really life-changing. A biomarker that’s positive, it doesn’t mean that the person will have dementia, but, you know, there is a big chance. So imagine if there is a chance of one in three that is a false positive. So we need to know these numbers, and we need to educate the population to be very careful what they are trying to see.
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