Spinal Fluid Test for Alzheimer’s Disease

A recent study published in Neurology points to some interesting results with measuring protein levels in cerebrospinal fluid (CSF). The research effort looked at levels of amyloid precursor protein (APPB) in patients with mild cognitive impairment (MCI), and found that the patients with high APPB levels at the beginning of the study period had a greater risk of declining into Alzheimer’s Disease within three years.

Biomarker tests such as CSF readings are very useful research tools, but most general news stories dance around the serious drawbacks with CSF tests in primary care settings. The only way to take a CSF sample is with an invasive procedure called a lumbar puncture, also known as a spinal tap. I don’t see many people signing up for a long needle being inserted into the lower spine, unless there is a pressing short term need, such as testing for meningitis.

Non-invasive screening options, such as computerized cognitive testing make more sense for general purpose use. Routine annual cognitive testing also allows for individual “baselines” to be established, which makes it easier to detect cognitive changes over time that can be highly relevant and notable for each patient.

Medicare recently established a new wellness benefit that includes cognitive screening; this is definitely a step in the right direction for catching early signs of cognitive impairment – *IF* primary care physicians implement some form of standardized cognitive tests that are sensitive to early signs of memory impairment.