Alzheimer's Disease biomarker testing

In this episode of The Good GP, Dr Krystyna de Lange speaks with Dr Steph Daly, GP with a special interest in aged care and dementia, about the introduction of plasma biomarkers, specifically the p-Tau 217 blood test for Alzheimer’s disease. They explore what the p-Tau 217 test measures, its reliability, and its role in primary care.

Dr Steph Daly outlines that the test shows high positive and negative predictive value for Alzheimer’s pathology when used in the appropriate, symptomatic patient group, typically those over 55 presenting with clear cognitive or memory symptoms. Discussing the practical process for GPs to request the test, expected costs, and considerations for both urban and rural settings.

They emphasise the need for pre-test counselling, careful patient selection, and the importance of structured clinical assessment to ensure meaningful use of the test. The application of this biomarker in asymptomatic individuals is not recommended at present, due to limited clinical utility and potential psychological harm.

Listeners are encouraged to approach the test thoughtfully, seek additional education, and use it initially in patients where clinical suspicion of Alzheimer’s disease is already high.

Links & Resources:

• Prognostic Value of Blood-Based P-Tau217 Levels for Progression to Cognitive Impairment study: https://jamanetwork.com/journals/jama/article-abstract/2851720
• The Nun Study: Insights from 30 years of aging and dementia research: https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.14626
• Link to webinar and information on biomarker study currently being carried out in Australia: https://www.australiandementianetwork.org.au/improved-extended-study-blood-based-biomarkers-for-alzheimers-disease-in-primary-care-project/

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