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Three-Minute Take-Home Test May Identify Symptoms Linked to Alzheimer's Disease

(www.smithsonianmag.com)
111 points pseudolus | 4 comments | 19 Sep 25 19:03 UTC | HN request time: 0.845s | source
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tptacek ◴[19 Sep 25 20:46 UTC] No.45306358[source]▶
The standard statistical caution for these kinds of screening tests is especially important here, because while Alzheimers drugs may be more effective earlier in the disease course, none of them are "effective" in the sense of meaningfully staving the disease off; the upside to early detection is not very strong.

Meanwhile: the big challenge for screening tests is base rate confounding: the test needs to be drastically more specific the lower the percentage of the cohort that truly has the condition is. Relatively low rates of false positives can pile up quickly against true positives for conditions that are rare in the population.

The bad thing here is: you get a test suggestive of early-onset Alzheimers. It could realistically be the case that the test positive indicates in reality a coin-flip chance you have it. But that doesn't matter, because it will take years for the diagnosis to settle, and your mental health is materially injured in the meantime.

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1. DavidSJ ◴[19 Sep 25 21:56 UTC] No.45307175[source]▶
while Alzheimers drugs may be more effective earlier in the disease course, none of them are "effective" in the sense of meaningfully staving the disease off; the upside to early detection is not very strong.

One correction here: the amyloid antibodies that successfully clear out a large amount of plaque have yet to report data from intervention trials prior to symptom onset, so we can’t say this with confidence and in fact we have good reason to suspect they would be more effective at this disease stage.

I wrote about this and related topics here: https://www.astralcodexten.com/p/in-defense-of-the-amyloid-h...

Edited to add: the sort of test discussed in the OP wouldn’t be relevant to presymptomatic treatment, however, since it’s a test of symptoms rather than biomarkers for preclinical disease.

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2. pedalpete ◴[19 Sep 25 22:38 UTC] No.45307593[source]▶
That is an amazing breakdown of AD, and I think it will be my go-to for sharing in the future.

Have you seen the research in phase-targeted auditory stimulation, memory, amyloid, and sleep? Do you have thoughts on that?

Acoustic stimulation during sleep predicts long-lasting increases in memory performance and beneficial amyloid response in older adults - https://doi.org/10.1093/ageing/afad228

Acoustic Stimulation to Improve Slow-Wave Sleep in Alzheimer's Disease: A Multiple Night At-Home Intervention https://doi.org/10.1016/j.jagp.2024.07.002

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3. DavidSJ ◴[20 Sep 25 02:03 UTC] No.45309439[source]▶
Thank you for your kind words.

I hadn’t seen that research, thanks for passing it along. It seems like an interesting approach to improve slow wave sleep, which is known to help with amyloid clearance.

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4. pedalpete ◴[20 Sep 25 02:25 UTC] No.45309646{3}[source]▶
If you're looking into this space further, I've posted the majority of the research on our website https://www.affectablesleep.com/how-it-works (bottom of the page)