Department of Defense Alzheimer's Disease Blood-Testing Initiative (DOD-ADBI): A Study to Accelerate Blood-Based Diagnosis of Alzheimer's in Veterans
Abstract
With the recent FDA-approval of the amyloid-targeting drug, Aducanumab, clinical practice has entered a new era of biomarker guided diagnosis and treatment of Alzheimer's disease (AD). FDA-approval of other amyloid-targeting drugs is expected soon. Scalable screening for brain amyloid and AD-associated tau (AD-tau) to inform allocation of these costly drugs is critical. Cerebrospinal fluid and PET studies are considered gold-standard for diagnosis of brain amyloid and tau in living patients, but will not be feasible for community-based screening. Emerging blood biomarkers may facilitate scalable diagnosis of AD per unbiased A/T (amyloid-tau) biomarker categorization. Unfortunately, prior studies of accuracy of these blood tests were done in non-Veterans, mostly in highly selected cohorts with minimal comorbidities. Traumatic brain injury, post-traumatic stress disorder, and cerebral small vessel disease (CSVD) are common in Veterans and may alter accuracy of blood biomarkers for AD diagnosis. While these military relevant exposures (MREs) are associated with increased risk for dementia, clinical and pathological features are more consistent with non-AD. It is unknown whether or how these highly prevalent MREs, atypical clinical features, and non-AD pathologies will effect blood-based AD diagnosis in Veterans. Due to atypical clinical features, it is also unclear which Veterans should be prioritized for AD biomarker testing in the first place. To address these gaps we will validate accuracy of leading A/T blood biomarkers in Veterans, determine whether MREs alter the relationship between A/T blood and neuroimaging biomarkers, and identify clinical predictors of A/T biomarker positivity. We will cost-efficiently leverage and extend DoD-ADNI.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2023
- Accession Number
- AD1227937
Entities
People
- Raquel C Gardner