A finger prick blood test combined with online brain testing – all done from home – could one day effectively identify people's risk of developing dementia, according to a new study.
Led by the University of Exeter and published in Nature Communications, the study found that the level of proteins linked to dementia which were measured in the postal blood test were linked to performance on a series of brain tests.
Funded by the National Institute for Health and Care Research (NIHR) Exeter Biomedical Research Centre, the research concludes that at-home testing could be a way to identify people at highest risk of dementia, who could then be prioritised for further testing, treatment and support. It could also identify people at low risk who could be given assurance, as well as those with moderate risk who may benefit from monitoring and guidance on reducing their risk in future.
Professor Anne Corbett, of the University of Exeter Medical School, led the research, and said: "Our previous research has shown that a finger-prick blood test can effectively be taken at home and posted to labs, and that we can identify the biomarkers in blood linked to dementia. This new study builds on that to show that we can link these biomarkers with performance on brain tests, giving us a potential way to predict risk of dementia.
"This work raises the potential for screening people for their risk without the need for clinic visits or complex clinical assessments. It would ensure the people at highest risk could be prioritised for monitoring and diagnosis, unlocking the best support and treatment for those that need it most."
The research was conducted in the online PROTECT study, in which more than 30,000 UK participants aged over 40 take regular cognitive tests to measure memory, attention and executive function, or decision-making skills.
The research included 174 PROTECT participants who were sent the at-home tests and administered it themselves, posting it back to the team. The researchers measured two proteins - Ptau 217, which is linked to Alzheimer's disease, and Gfap, linked to broader brain decline. They found that performance on the brain tests correlated with the presence of the proteins, with tau emerging with the strongest links. This enabled the team to categorise people at low, medium and high risk.
Professor Clive Ballard, of the University of Exeter Medical School, was involved in the research. He said: "Almost a million people in the UK are estimated to have dementia, yet at the moment, only one in a thousand people with the earliest signs of brain decline receives a specialist evaluation. Our approach of combining our robust cognitive testing with measuring proteins via a postal blood test could provide a straightforward, efficient and cost-effective method to reach large numbers of people in the community who would not otherwise be prioritised for the next steps of diagnosis or support and to optimise the clinical pathway to enable early detection of those at highest risk.
"We need further research to validate this approach, and I'd encourage anyone aged 40 or over to join us by signing up to PROTECT."
Professor Marian Knight, NIHR Scientific Director for NIHR Infrastructure, said: "The potential of this combination of cognitive and blood tests – both of which can be done at home – is really exciting. Not only could it reduce the burden on the NHS by screening people in their own homes rather than in hospitals or clinics, but it also might mean we can identify people with dementia earlier, tailor treatments more effectively, and improve outcomes for patients. This is a fantastic example of research teams in NIHR infrastructure working together to deliver real change for the public and the NHS, in line with government priorities."
The study was also supported by the NIHR HealthTech Research Centre in Brain Health and the NIHR Applied Research Collaboration South West (ARC SW).
