With the advancement of technology, we can improve the accuracy of peripheral blood diagnosis of Alzheimer's disease to over 90%. Now, multiple diagnostic companies have contacted us to carry out achievement transformation. Recently, Alzheimer's disease (AD) expert Yu Jintai revealed to Interface News.

Yu Jintai is the Vice Dean of the Institute of Science and Technology at Fudan University, the Director of the Research Department at Fudan University Shanghai Medical College, and the Deputy Director of the Neurology Department at Fudan University Affiliated Huashan Hospital. Previously, he and the team led by Professor Mao Ying, the director of Huashan Hospital, collaborated with Professor Feng Jianfeng and Professor Cheng Wei from Fudan Institute of Brain Intelligence Science and Technology to conduct a study that identified new peripheral blood protein targets for Alzheimer's disease. By drawing blood, the risk of dementia can be predicted 15 years in advance, with an accuracy exceeding 90% for the first time globally.

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

'Earlier and more accurate' is the current trend in the development of AD diagnosis.

According to Yu Jintai, traditional clinical inquiry and scale diagnosis are not accurate enough and cannot provide early judgment. With breakthroughs in the research of specific biomarkers related to AD, doctors can now diagnose early to mid stage AD through PET (positron emission tomography)/CT and magnetic resonance imaging. However, the disadvantage is the high cost, which is currently only available in some top tier tertiary hospitals in China.

In addition, currently the most commonly used clinical method for diagnosis is through cerebrospinal fluid, but extracting cerebrospinal fluid requires lumbar puncture, which is invasive and requires hospitalization. Generally, asymptomatic patients will not undergo such examinations.

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

This is thanks to big data-driven research, "said Yu Jintai. They relied on the multidisciplinary advantages of Fudan University as a comprehensive university, with strong algorithm and computing power support provided by the Fudan Institute of Brain Intelligence Science and Technology, and efficiently screened proteomic indicators in a short period of time. Previously, we may have used candidate strategies and needed to see which indicators might be useful before attempting. The analysis cycle was long, but now we directly use omics, proteomics, metabolomics, and genomics to process massive amounts of data and achieve larger scale screening

The joint team analyzed the plasma proteome data of over 50000 people and established associations between 2920 plasma proteins and 720 diseases and 986 health-related phenotypes, creating the most comprehensive human health and disease plasma proteome map currently available. At the same time, they established an open access "proteome phenotype" 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 findings have been featured on the cover of the international medical journal Cell for the opening year of 2025. This is also one of the major projects of "Brain Science and Brain like Research" for technological innovation 2030.

Yu Jintai has been deeply involved in the field of Alzheimer's disease for many years. According to its introduction, AD is a neurodegenerative disease commonly known as senile dementia. With the increase of age, the incidence rate of AD is higher. The incidence rate among people aged 60 and above is about 5%, but it may rise to nearly 20% in those aged 70 and above, and reach 30% to 40% in those aged 90 and above.

From a global perspective, AD is showing a doubling trend every twenty years, with a trend towards youthfulness. According to the "China Alzheimer's Disease Report 2024", there were nearly 17 million cases of AD and other dementia related diseases in China in 2021, accounting for nearly 30% of the global total. Among them, the incidence and mortality rates of women were higher than those of men; Shanghai has the second highest incidence rate in the country.

Yu Jintai pointed out that the reason for the increase of AD incidence rate, on the one hand, is that people's understanding of AD is getting deeper and deeper, and diagnostic technology is becoming more advanced and popular; On the other hand, chronic diseases such as hypertension, diabetes and cardiovascular diseases all show an early onset trend, and these chronic diseases are also risk factors for AD; In addition, it also involves various factors such as environment, diet, and social pressure.

In 2023, the Alzheimer's Association International Conference released a new version of the diagnostic criteria for Alzheimer's disease, bringing new ideas to the diagnosis and treatment of AD. According to the new standards, AD diagnosis is divided into 7 stages from 0-6. Among them, patients in stage 1 have no symptoms but have abnormal biomarkers, while patients in stages 2 to 6 have varying degrees of cognitive impairment.

Yu Jintai said that the period of pathological changes in the brain of AD patients without symptoms is about 15-20 years, and then it further develops into symptomatic but not severe symptoms for about 3-5 years. It may then further develop into dementia, where symptoms are more severe and affect the independence of daily life and work. This period is about 5-8 years. When patients present with severe symptoms and seek medical attention, they are often already in the late stages of the disease. Therefore, early prevention, diagnosis, and treatment are crucial.

The hidden onset, large patient scale, heavy disease burden, and increasing disability of AD have become prominent issues, which have attracted high attention from the country and the World Health Organization.

The World Health Organization has released the Global Action Plan for Addressing Dementia in the Public Health Sector (2017-2025), which requires governments around the world to develop strategies, plans, policies, and programs to address dementia based on their own national conditions. In 2019, the State Council issued the "Opinions on Implementing the Healthy China Action Plan", which set "by 2030, the growth rate of dementia in the elderly population aged 65 and above will decrease" as one of the outcome indicators.

In January of this year, the National Health Commission and 15 other departments jointly issued the "National Action Plan for Addressing Dementia in the Elderly (2024-2030)", aiming to establish a comprehensive and continuous prevention and control system for dementia prevention, screening, diagnosis, treatment, rehabilitation, and care by 2030, effectively controlling the growth rate of dementia in the elderly.

The above action plan requires promoting the initial screening of cognitive function in elderly people aged 65 and above; Carry out early interventions such as guidance on healthy lifestyle, risk factor management, and cognitive training; Increase the supply of care services for elderly people with dementia; Strive to make breakthroughs in exploring the pathogenesis of dementia in the elderly, developing new technologies for prevention, diagnosis, treatment, and rehabilitation, creating new therapeutic drugs, and developing traditional Chinese medicine prevention and treatment plans.

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

Previously, drugs for AD were mostly in the neurotransmitter field, used to improve clinical symptoms. Last year, two imported innovative drugs for early AD treatment were approved for market in China, which can delay the development process of early AD.

According to a report by China News Service, at the "Advanced Expert Forum on Innovative Surgical Treatment of Alzheimer's Disease" held on February 16th, Xiao Shifu, director and department director of the Elderly Mental Disease Diagnosis and Treatment Center of Shanghai Mental Health Center, stated that in the future, treatment will pay more attention to "fundamentally changing the disease process", that is, using new technologies such as nano delivery and immune regulation to enhance the therapeutic effect of drugs, so that patients' symptoms can be improved for a longer period of time and more stably.

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

Currently, prevention remains one of the most important measures.

In 2023, Yu Jintai's team screened 62 controllable risk factors for dementia and created the first dementia controllable risk factor map. The study found that 47.0% -72.6% of dementia could be prevented through active intervention. He suggested going to bed at 10 pm, maintaining 7 hours of sleep, exercising more, and sitting less, which can reduce the likelihood by 40%. At the same time, by using your brain more, maintaining a good mood, changing bad habits such as smoking and drinking, controlling blood pressure and blood sugar, you can reduce the likelihood of developing the disease on a larger scale. He revealed that this year the team will also release the best dietary patterns for preventing AD.