ALZHEIMER'S DISEASE: A NEW BLOOD TEST

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 ALZHEIMER'S DISEASE: A NEW BLOOD TEST






A routine blood test could help doctors spot which early Alzheimer's patients are most likely to deteriorate quickly, according to new research presented at the 2025 European Academy of Neurology Congress. The study highlights the triglyceride-glucose (TyG) index—a standard measure of insulin resistance—as a potential key predictor. People with high TyG scores were four times more likely to experience rapid cognitive decline than those with lower scores.

Researchers from the University of Brescia analyzed medical records from 315 non-diabetic patients with cognitive problems, including 200 with confirmed Alzheimer's. All participants had their insulin resistance measured using the TyG index and were followed for three years. Those in the highest third for TyG in the group with mild cognitive impairment due to Alzheimer's lost more than 2.5 points per year on the Mini-Mental State Examination, a standard cognitive test. No similar association was found among patients with other types of cognitive impairment.

Dr. Bianca Gumina, the study's lead investigator, emphasized the practical value of this finding: "A simple metabolic marker that's already available in hospital labs can help identify patients at higher risk, making it possible to tailor therapies and intervention plans."

While insulin resistance has long been linked to the development of Alzheimer's, its role in how quickly the disease progresses hasn't been well studied. This research focused on the early, mild cognitive impairment stage, where disease progression can vary widely from person to person. The TyG index, which is easy to obtain from routine blood work, gave researchers a way to test whether metabolic health might influence the speed of cognitive decline after diagnosis.

The team found that insulin resistance appeared to worsen outcomes in Alzheimer's specifically, but not in other neurodegenerative disorders. In Alzheimer's, insulin resistance may hinder the brain's ability to process glucose, encourage the buildup of amyloid plaques, disrupt the blood-brain barrier, and increase inflammation, factors less relevant in other forms of dementia.

Another finding was that high TyG scores were linked to blood-brain barrier disturbances and cardiovascular risk, but were not connected to the APOE444 genetic risk factor for Alzheimer's. Biological and genetic risks may drive the disease through separate biological pathways.

Identifying patients with high TyG scores could help refine clinical trial enrollment for new Alzheimer's patients and prompt earlier interventions—like medications or lifestyle changes—to improve insulin sensitivity. The researchers are now exploring whether TyG levels also correspond with early changes seen on brain scans.

"If targeting metabolism can slow the disease, we have a modifiable risk factor to work on, right alongside new disease-modifying treatments," Dr. Gumina said.

References:

Gumina B., Galli A., Tolassi C. et al. The Triglyceride-Glucose Index as a Predictor of Cognitive Decline in Alzheimer's Disorders. Presented at the European Academy of Neurology (EAN) Congress 2025; 23 June 2025; Helsinki, Finland.

Padovani A., Galli A., Bazzoli E., et al. (2025). Insulin resistance and APOE genotype in blood-brain barrier integrity in Alzheimer's disease. Alzheimer's Advance online publication. https://doi.org/10.1002/alz.14556

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