BLOOD SCIENCES
this study it may be concluded that not only could PV be used as an important biomarker in suspected dementia but can also be a significant marker in the differential diagnosis between Alzheimer’s and vascular dementia. A further study by van Oijen et al.15 found that fibrinogen was significantly increased in patients with dementia. This will be indicated by a detectable increase in the plasma viscosity and also that… “high levels of C- reactive protein (CRP) were not associated with an increased risk of dementia”. Similarly in a paper by Marioni et al.16
the authors found that:
“Elevated plasma viscosity predicted poorer subsequent cognitive ability and were associated with age-related cognitive decline in several domains including general ability.”
A PET scan or lumbar puncture are the ‘gold standard’ diagnostic methods to confirm Alzheimer’s, but only 2% of dementia patients undergo these currently.
indicate that caregivers of individuals with dementia face the highest rates of anxiety and depression.7
Determining Alzheimer’s
and vascular dementia disorders at an early stage significantly decreases the likelihood of caregivers developing anxiety and depression. The incidence of dementia reveals
alarming statistics. It is the seventh leading cause of death in the world,8
It with
ten million new cases reported worldwide every year. In 2017 there were 55 million people living with the condition.9
has been estimated that by 2050 the number of cases of people living with dementia will be 150 million.10
In 2019,
the estimated number of individuals aged 65 years and older living with dementia in the UK was approximately 885,000. However, it is projected that by the year 2040, this figure will rise significantly to almost 1.6 million due to continuous increase in life expectancy.11 To receive a diagnosis, an individual must be in the initial phase of Alzheimer’s and must have undergone a positron emission tomography (PET) scan or lumbar puncture to confirm the presence of high amyloid protein levels in the brain. Alzheimer’s Research UK reports that a mere 2% of dementia patients currently undergo these ‘gold standard’ diagnostic methods. This really is a frightening situation. The costly PET scan, the highly invasive lumbar puncture, and the extensive waiting list for these procedures may considerably delay the diagnosis. A simple, readily available, easy to obtain and inexpensive plasma viscosity test will provide reliable data that can serve as a crucial contribution for vascular dementia and Alzheimer’s diagnosis.
However, currently just less than two-
thirds of individuals affected by dementia receive any form of diagnosis. There are many factors that can lead to delay but there is optimism that a blood test capable of detecting amyloid protein levels may become accessible sometime in the future.
A study of plasma viscosity in dementia
The viscosity of plasma is determined by the concentration of the large asymmetric molecules such as fibrinogen.12
An
increase in fibrinogen and changes in other acute-phase reactants increases the viscosity of the plasma.13 The relationship between dementia and blood flow (haemorheology) has been studied. In a 2013 paper by Aras et al.14
the authors found that plasma viscosity was considerably raised in patients with dementia compared with the age-matched non-dementia control group. Furthermore, they found that plasma viscosity was also significantly increased in patients with vascular dementia compared to those with Alzheimer’s disease. Therefore, from
Is it Alzheimer’s or vascular dementia?
Initial studies have been undertaken to determine whether it is possible to differentiate between Alzheimer’s and vascular dementia rapidly by using an approved, readily available, and cost- effective test. There are clear indications that the plasma viscosity test could be the golden key to clearly define the difference between Alzheimer’s and vascular dementia. It is recognised that further investigation should be carried out to provide additional support for the hypothesis.
It will be a game changer when we can confidently distinguish the difference in the plasma viscosity ranges between potentially treatable Alzheimer’s and incurable vascular dementia. Comparison of the simple numerical
results reported by the plasma viscosity test will better determine treatment pathways and therefore subsequently improve patient outcome.
Measurement of plasma viscosity
Plasma viscosity (PV) is renowned as a quick, inexpensive, non-specific test, but also capable of being a more
There are clear indications that the plasma viscosity test could be the golden key to clearly define the difference between Alzheimer’s and vascular dementia. It is recognised that further investigation should be carried out to provide additional support for the hypothesis
WWW.PATHOLOGYINPRACTICE.COM DECEMBER 2024 35
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