p tau?

[Kikiwebb]

My Functional medicine primary - bresden trained - is ordering a p tau. I am scared. has anyone else gotten this blood test? if its positive, am I going to lose my mind and ruin th rest of my life? can we even do anything about it?

[NF52]

My Functional medicine primary - bresden trained - is ordering a p tau. I am scared. has anyone else gotten this blood test? if its positive, am I going to lose my mind and ruin th rest of my life? can we even do anything about it?

It's incredibly unlikely that you will have a positive p-tau test at the age of 48 with ApoE 3/4. Whatever version of a p-tau test your doctor ordered, and there are several, is NOT predicting tau tangles in your brain. Instead it's showing circulating p-tau in your blood, which occurs BEFORE tau tangles and is a predictor of having at least "measurable" or "intermediate' levels of amyloid plaques. Amyloid plaques develop VERY slowly for a decade or two and rarely speed up until the 60's even in ApoE 4/4 carriers.

Below is a screenshot of well-designed study of the Association Between Apolipoprotein E ε2 vs ε4, Age, and β-Amyloid in Adults Without Cognitive Impairment. They did PET scans on 4,432 people with normal cognition in Sweden, where the most cutting-edge research on PET scans is done. The green line in the picture below shows ApoE 3/4 carriers. The fact that it is very thin means that 95% of people were in that very narrow range. At age 65 almost all people in that study with ApoE 3/4 were only at the very lowest level of what is might be considered "amyloid positivity of 1.12 SUVR (that's a technical term for Standard Uptake Value Ratio). You can also see that it wasn't until they were about 75 that they reached the level of 1.20

Amyloid Positivity by age and ApoE status .png

Amyloid levels are considered "intermediate" in the AHEAD-3 prevention trial at 1.20, with everything below that considered not likely to rapidly change. AHEAD sites do not screen anyone below age 55, but found that almost NO ONE ages 55-59 qualified at that level--even those with ApoE 4/4. We've had several members in their late 50's with ApoE 4/4 who were ineligible for AHEAD because their PET scans were below the 1.2 level.

But even with "elevated" amyloid, which I had in a PET scan at age 65, a person's life is not over and they are not going to lose their mind. I know several people living with mild AD dementia. You could talk to them on Zoom, which they use along with email, texts, etc. and enjoy their sense of humor, their appreciation for travel, photography, going to concerts, spending time advising people at the NIH on best practices for clinical trials and advocating for seeing people with AD as "People First". And they also like to swim, hike, eat healthy foods, do Wordle on the NYT and play board games with college students. Alzheimer's is a disease that people are learning how to manage and still live with joy.

Let us know the results of the test. And please give yourself permission to hold off on any more tests until your 60's.

Nancy

[Kikiwebb]

thank YOU AGAIN NANCY!