"With the advancement of technology, we can achieve an accuracy rate of more than 90% in peripheral blood diagnosis of Alzheimer's disease. Now many diagnostic companies have contacted us to carry out results transformation." Recently, Alzheimer's disease (hereinafter referred to as AD) expert Yu Jintai revealed to Jiemian News.

Yu Jintai is the deputy dean of Fudan University Institute of Science and Technology, director of the Research Department of Shanghai Medical College of Fudan University, and deputy director of the Department of Neurology of Huashan Hospital Affiliated to Fudan University. Previously, he and the team of Professor Mao Ying, dean of Huashan Hospital, jointly with the team of Professor Feng Jianfeng and Cheng Wei of Fudan Brain-like Intelligence Science and Technology Research Institute, led a study to find a new AD peripheral blood protein target. Blood draws can predict the risk of dementia 15 years in advance, with an accuracy of more than 90% for the first time in the world.

In early 2024, the above research results were published in the journal Nature Aging.

“Earlier and more accurate” is the current development trend of AD diagnosis.

According to Yu Jintai, traditional clinical inquiries and scale diagnoses are not accurate enough and cannot provide judgments at an early stage. With the breakthrough in the research progress of specific biomarkers related to AD, doctors can now diagnose early and middle-stage AD through PET (positron emission tomography)/CT and magnetic resonance imaging. The disadvantage is that it is expensive and can only be achieved in some top tertiary hospitals in China.

In addition, the most commonly used clinical method is to diagnose through cerebrospinal fluid, but the extraction of cerebrospinal fluid must be achieved through lumbar puncture, which is invasive and requires hospitalization. Generally, patients without symptoms will not undergo such examinations.

The latest peripheral blood diagnosis has improved the existing diagnostic methods for AD. On this basis, the joint team will expand the research target to all health-related diseases, further comprehensively map the human proteome phenotype group map, and create a new paradigm for disease research.

“This is due to big data-driven research.” Yu Jintai said. Relying on the multidisciplinary advantages of Fudan University, with the powerful algorithm support and computing power support provided by Fudan Brain-like Intelligence Science and Technology Research Institute, they efficiently screened the proteomic indicators in a short time. "We may have adopted a candidate strategy before, and we need to see which indicator may be useful before trying it. The analysis cycle is very long. Now we directly use omics, proteomics, metabolomics and genomes, which can process massive data and achieve larger-scale screening."

The joint team analyzed the plasma proteomic data of more than 50,000 people, and established associations between 2,920 plasma proteins and 720 diseases and 986 health-related phenotypes, drawing the most comprehensive human health and disease plasma proteomic map. At the same time, they established an openly accessible "proteome-phenotype group" resource database to share the latest research results with the world.

This means that in the future, hundreds of diseases including Alzheimer's disease can be predicted through peripheral blood testing.

The research results appeared on the cover of the international medical top journal Cell in 2025. This is also one of the major projects of "Brain Science and Brain-like Research" in Science and Technology Innovation 2030.

Yu Jintai has been deeply involved in the field of Alzheimer's disease for many years. According to him, AD is a neurodegenerative disease, commonly known as senile dementia. The incidence of AD increases with age. The prevalence of people over 60 years old is about 5%, but it may rise to nearly 20% for people over 70 years old, and the prevalence of people over 90 years old may reach 30% to 40%.

Globally, AD shows a growth trend of doubling every 20 years, and there is a trend of younger people. According to the "China Alzheimer's Disease Report 2024", in 2021, the number of people with AD and other dementia diseases in my country will be nearly 17 million, accounting for nearly 30% of the total number of patients worldwide, among which the prevalence and mortality rates of women are higher than those of men; Shanghai's prevalence ranks second in the country.

Yu Jintai pointed out that the reason for the increase in the incidence of AD is that, on the one hand, people have a deeper understanding of AD, and diagnostic technology is becoming more advanced and popular; on the other hand, chronic diseases such as hypertension, diabetes, and cardiovascular disease are all showing an early onset trend, and these chronic diseases are also risk factors for AD; in addition, various factors such as environment, diet, and social pressure are also involved.

In 2023, the Alzheimer's Association International Conference announced a new version of the AD diagnostic criteria, which brought a new concept to the diagnosis and treatment of AD. According to the new standard, AD diagnosis is divided into 7 stages from 0 to 6. Among them, patients in stage 1 have no symptoms but have abnormal biomarkers, and patients in stages 2 to 6 have different degrees of cognitive impairment.

Yu Jintai said that the cycle of pathological changes in the brain of AD patients but no symptoms is about 15-20 years, and then it will further develop to symptoms but not severe symptoms for about 3-5 years, and then it may further develop to the dementia stage, with more severe symptoms, affecting the independence of daily life and work, and this cycle is about 5-8 years. When patients come to the doctor with severe symptoms, they are often in the late stage of the disease. Therefore, early prevention, diagnosis and treatment are very critical.

AD has a hidden onset, a large number of patients, a heavy disease burden, and increasing disability, which has attracted great attention from the country and the World Health Organization.

The World Health Organization issued the "Global Action Plan for Dementia in Public Health (2017-2025)", requiring governments around the world to formulate strategies, plans, policies, programs and other documents to deal with dementia based on their own national conditions. In 2019, the State Council issued the "Opinions on Implementing the Healthy China Action Plan", setting "By 2030, the growth rate of the prevalence of senile dementia in people aged 65 and above will decrease" as one of the outcome indicators.

In January this year, the National Health Commission and 15 other departments jointly issued the "National Action Plan for Alzheimer's Disease (2024-2030)", with the goal of basically establishing a comprehensive and continuous prevention and control system for the prevention, screening, diagnosis, treatment, rehabilitation and care of senile dementia by 2030, and effectively controlling the growth rate of the prevalence of senile dementia.

The above action plan requires the promotion of cognitive function screening for the elderly aged 65 and above; the implementation of early intervention such as healthy lifestyle guidance, risk factor management and cognitive training; the increase of care services for the elderly with dementia; and the efforts to make breakthroughs in exploring the pathogenesis of senile dementia, developing new technologies for prevention, diagnosis and rehabilitation, creating new therapeutic drugs, and developing traditional Chinese medicine prevention and treatment programs.

In addition to diagnosis, AD drug treatment has also ushered in a leapfrog development.

Earlier, AD drugs were mostly neurotransmitter drugs used to improve clinical symptoms. Last year, two imported innovative drugs for early AD treatment were approved for marketing in my country, which can delay the development of early AD.

According to China News Service, at the "Advanced Expert Forum on Innovation in Surgical Treatment of Alzheimer's Disease" held on February 16, Xiao Shifu, director and department director of the Geriatric Mental Disease Diagnosis and Treatment Center of Shanghai Mental Health Center, said that future treatment will focus more on "fundamentally changing the course of the disease", that is, through new technologies such as nano-delivery and immune regulation, to improve the therapeutic effect of drugs, so that patients' symptoms can be improved in a longer-term and more stable manner.

Yu Jintai said that the disease mechanism of AD is very complex, and drug research will be a long process. In the future, gene therapy and stem cell therapy are more promising. The brain-computer interface, which has been popular recently, is also a new tool, but it is still far from reaching the level of decoding memory. "If we really want to conquer AD, I hope that one day in the future we can get vaccinated to prevent and improve it."

At present, prevention is still one of the most important measures.

In 2023, Yu Jintai's team screened out 62 adjustable risk factors for dementia and drew the first adjustable risk factor map for dementia. The study found that 47.0%-72.6% of dementia can be prevented through active intervention. He suggested that going to bed at 10 o'clock in the evening, staying asleep for 7 hours, exercising more, and sitting less can reduce the possibility by 40%. At the same time, using your brain more, maintaining a good mood, changing bad habits such as smoking and drinking, and controlling blood pressure and blood sugar can reduce the possibility of disease in a larger range. He revealed that this year the team will also release the best dietary pattern for preventing AD.

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