公共卫生 公共卫生
Zachary Sheff1, Nalin Payakachat1, E Jolanda Muenzel1
1Eli Lilly & Company, Indianapolis, IN, USA.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 23, 2025
概括
数以百万计的老年人患有临床前阿尔茨海默病 (AD),通过生物标志物证据确定. 基于血液的生物标志物,如血p-tau217,可以识别那些患有认知衰退风险最高的人,帮助未来的治疗策略.
科学领域:
- 神经学和老年学的神经学和老年学.
- 生物标志物发现发现
- 流行病学 流行病学
背景情况:
- 临床前阿尔茨海默氏症 (AD) 的特点是,在认知不受损的个体中,有AD病理学的生物标志物证据.
- 目前的诊断方法 (PET扫描,脑脊液采集) 是侵入性的,对于没有认知障碍的人群来说不是标准的.
- 基于血液的生物标志物 (BBM) 为AD检测提供了一种最小侵入性,可扩展性和成本有效的替代方案.
研究的目的:
- 估计美国,日本,德国和中国50岁以上临床前AD患有认知衰退最大风险的个体数量.
- 评估血p-tau217水平在识别高风险的临床前阿尔茨海默病患者群体中的潜在有用性.
- 为未来的AD干预提供医疗保健基础设施和预算规划的信息.
主要方法:
- 利用国家特定的人口普查数据和基于文献的痴呆症,MCI和粉样蛋白PET阳性的流行率估计.
- 应用了最近的发现,将顶端三角质血p-tau217水平与粉样蛋白阳性,认知不受损的个体中临床进展的最高速率联系起来.
- 通过考虑三分之一的粉样蛋白-PET阳性临床前AD人群来估计高风险的临床前AD人群.
主要成果:
- 根据粉样蛋白PET阳性估计的临床前AD人群 (50+):美国 (22.0M,18.3%),日本 (11.2M,19.0%),德国 (7.0M,18.5%) 和中国 (90.7M,17.0%).
- 估计高风险的临床前阿尔茨海默病人群 (顶端三位数p-tau217):美国 (73万,6.1%),日本 (37万,6.3%),德国 (23万,6.2%) 和中国 (3020万,5.7%).
结论:
- 显著的临床前阿尔茨海默病患者数量凸显了有效查方法的必要性.
- 像血p-tau217这样的基于血液的生物标志物可以帮助识别高风险个体,可能减少医疗保健负担.
- 对临床前阿尔茨海默病的血p-tau217患病率的进一步研究对于经济影响评估和治疗规划至关重要.
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