新研究表明血液检测可预测健康老年人早期痴呆风险Blood Test Predicts Early Dementia Risk in Healthy Older Adults, Study Shows

哈佛医学院神经学副教授、该研究的第一作者雷切尔·巴克利（Rachel Buckley）表示，这项研究表明，未来医疗人员确实可以使用p-tau217血液检测来评估个人发生认知障碍的风险。在传统的临床诊断中，确认阿尔茨海默病通常需要依赖昂贵且具有侵入性的程序，例如正电子发射断层扫描（PET扫描）或腰椎穿刺。而最新的研究表明，通过检测血液中磷酸化tau 217（即p-tau217）的水平，可以强力预测大脑中粘性β-淀粉样蛋白斑块的积聚。

According to the lead study author Rachel Buckley, an associate professor of neurology at Harvard Medical School, the findings demonstrate that clinicians can indeed use p-tau217 blood tests in the future to understand an individual's personal risk of cognitive impairment. Traditionally, diagnosing Alzheimer's disease has required expensive and invasive procedures, such as positron emission tomography (PET) scans or spinal taps. In contrast, this blood test measuring levels of phosphorylated tau 217, or p-tau217, strongly predicts the buildup of sticky beta-amyloid plaques in the brain.

根据发表在《美国医学会杂志》等渠道的研究结果，在五年内，血液中p-tau217水平较高的无症状老年人出现早期痴呆症状的估计风险高出38%。而在十年的跨度内，这一风险估计高出78%，不过研究人员也指出，由于时间跨度较长，十年期的数据在统计学上不如五年期的数据那样稳健。这项研究为未来在无症状阶段识别高风险个体提供了新的科学依据。

The study found that cognitively healthy older adults with elevated levels of the p-tau217 biomarker had an estimated 38% greater chance of developing early signs of dementia over a five-year period. Over a ten-year period, the estimated risk of developing these symptoms rose to 78% higher. However, researchers noted that the ten-year data was not as robust as the five-year findings, though the biomarker remains a powerful predictor of early pathology.

研究表明，p-tau217生物标志物能够强力预测大脑中粘性β-淀粉样蛋白斑块的积聚。这些淀粉样蛋白斑块会引发炎症并破坏神经元之间的通信。它们可能在人们出现记忆丧失或认知能力下降前数十年就已开始在大脑中聚集，甚至在人们三十多岁和四十多岁时就已经存在。随着大脑中β-淀粉样蛋白水平的上升，一种被称为tau蛋白的蛋白质缠结开始在脑细胞内部聚集，导致神经元崩溃并死亡。

Research shows that the p-tau217 biomarker strongly predicts the buildup of sticky beta-amyloid plaques in the brain. These amyloid plaques trigger inflammation and damage communication between neurons. They can collect in the brain decades before memory loss or cognitive decline begins, even when individuals are in their 30s and 40s. As beta-amyloid levels rise in the brain, tangles of proteins called tau begin gathering inside brain cells, causing neurons to collapse and die.

然而，研究人员也指出，大脑病理变化与最终发展为痴呆之间并非绝对的因果关系。雷切尔·巴克利表示，并非所有体内含有高水平淀粉样蛋白的人都会发展为痴呆，正如大脑中存在tau蛋白并不意味着未来一定会发生认知障碍。此外，在某些损害执行功能而非记忆的疾病（如额叶痴呆）中，tau蛋白缠结可能会在没有淀粉样蛋白存在的情况下积聚。

However, researchers emphasize that brain pathology does not guarantee the onset of clinical symptoms. According to study author Rachel Buckley, not everyone with high levels of amyloid will progress to dementia, just as having tau in the brain does not dictate cognitive impairment later in life. Furthermore, in some diseases such as frontal lobe dementia, which damages executive function instead of memory, tau tangles can accumulate without the presence of amyloid.

尽管目前该检测不建议用于普通健康人群，但研究人员指出，这项血液检测在当前的实际应用价值在于作为一种强有力的筛查工具，用以加速阿尔茨海默病新药的研发。目前，已有大型临床试验正在测试某些药物是否能够预防或至少延迟该疾病的发生。如果这些药物被证实有效，医生将需要一种简便且易于普及的方法，来快速识别哪些人群应该接受这些治疗。

Although the test is not currently recommended for the general healthy public, researchers emphasize its immediate practical value as a powerful screening tool to accelerate the development of new Alzheimer's drugs. Currently, large-scale clinical trials are already underway to test whether certain experimental drugs can prevent or at least delay the onset of the disease. If any of these preventive treatments prove successful in trials, healthcare providers will urgently need an easy, accessible, and non-invasive method to identify which individuals should receive them.

该检测能够帮助科研人员在无症状阶段识别出高风险人群，并将其招募到旨在预防或延迟阿尔茨海默病的临床药物试验中。通过这种方式，p-tau217血液检测可以显著提高临床试验的效率，帮助筛选出最适合参与相关治疗或预防策略研究的受试者，从而为未来阿尔茨海默病的治疗和干预手段带来新的突破。

By identifying high-risk individuals before they show any cognitive symptoms, the p-tau217 blood test can help researchers enroll the right candidates into clinical trials for preventive strategies. This screening capability is expected to streamline and speed up clinical research, making it easier to test potential therapies on the populations most likely to benefit, which could eventually transform how the disease is diagnosed and treated.

尽管这项研究展示了血液检测的巨大潜力，但科学家和研究人员强调，目前健康人群寻求这种p-tau217检测还为时过早。该检测目前的实际临床用途，是辅助诊断那些已经出现认知障碍或相关症状的人群，以确定其是否患有阿尔茨海默病或其他神经退行性疾病。对于目前没有任何症状的健康公众而言，进行该项检测并不能改变现有的临床干预手段。

Despite the promising findings of the study, scientists and researchers stress that it is too soon for healthy individuals to seek out the p-tau217 blood test. Currently, the clinical application of this test is limited to helping diagnose whether people who are already experiencing cognitive problems have Alzheimer's disease or another neurological disorder. For the general healthy public without symptoms, undergoing this test at this stage would not alter any current medical interventions or treatment plans.

该研究的资深作者、麻省总医院布里根神经科学研究所的雷萨·斯珀林（Reisa Sperling）医生强调，公众应当等到有可行治疗手段时再考虑进行检测。斯珀林医生指出，在当前阶段，检测结果并不会改变她对健康人群的医学建议。她呼吁公众目前应专注于保持健康的生活方式，包括良好饮食、充足睡眠、大量运动以及保持积极的社交活跃，这些健康习惯才是目前预防和应对认知衰退的有效途径。

Dr. Reisa Sperling of the Mass General Brigham Neuroscience Institute, the senior author of the study, advised people to wait and get tested only when they can potentially do something about the results. Dr. Sperling emphasized that, at this point, a test result would not change her medical advice for healthy individuals. Instead, she urged the public to focus on maintaining healthy lifestyle habits, advising them to eat well, sleep well, exercise a lot, and stay socially engaged.