In a study with people who had normal cognitive ability, researchers found that the blood levels of glial fibrillary acidic protein (GFAP) increased more rapidly in people at risk of future Alzheimer’s disease than those without the risk of the disease. Protein GFAP locates in the cells that support the nerve cells in the central nervous system in our brain. These findings suggest the potential to measuring blood GFAP to track Alzheimer’s disease progression for at-risk people. 

Structural and functional worsening of the brain can appear at least 10 years before any symptoms of Alzheimer’s disease occur in a person. Reliable blood-based biomarkers can allow clinicians measure potential disease progression in people with preclinical Alzheimer’s. Preclinical Alzheimer’s is a condition that people show accumulation of both the protein amyloid and tau measured by brain imaging, in the brain before any cognitive symptoms occur. Accumulation of these proteins in the brain may indicate structural and functional worsening of the brain.

The study investigated changes in blood levels of several biomarkers over four years in 373 individuals aged 60 years or older, with or without preclinical Alzheimer’s; 21 of the participants were at the preclinical phase. All participants had either parents or at least two siblings with Alzheimer’s, which increased their risk of developing the disease. Among these biomarkers, the researchers measured GFAP levels.

The researchers found that blood levels of GFAP increased notably faster in people with preclinical Alzheimer’s than those without the condition over four years. This suggests the potential of using blood GFAP to monitor Alzheimer’s progression for at-risk people with normal cognitive ability. 

This study also showed the differences in the GFAP levels between female and male. Based on the data from the entire cohort of people with or without preclinical Alzheimer’s; females had higher GFAP levels than males at the beginning of the study. The GFAP levels also increased faster in females than in males. 

The findings of this study moved us a step closer to using blood GFAP to track Alzheimer’s progression among people who are at the preclinical phase. At the same time, we need to recognize the limitations of this study, including the small cohort of participants with preclinical Alzheimer’s and limited racial diversity. Future studies can evaluate longer follow-up time, more participants, and diverse racial groups. This will move GFAP, as a blood-based biomarker, closer to its future use in clinical studies and the clinic.

This study was published in Alzheimer’s & Dementia. Image credit: Canva

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