The Pin Prick Blood Test that Predicts Dementia Risk from Middle Age

A new pinprick blood test that not only aims to predict your future risk for dementia but tells you how to reduce it is launched today as part of a global prevention research study aiming to involve a million people worldwide.

The home-test kit from the charity FoodfortheBrain.org measures your blood sugar, vitamin D, omega-3 and B vitamin status, which account for more than half the modifiable risks for dementia. The results show how a person can reduce risk with specific diet changes.

“Alzheimer’s is a preventable but not reversible disease. Less than one in a hundred cases are directly caused by genes. Prevention is entirely possible if you can identify who is at risk early enough and encourage the right diet and lifestyle changes.” says Patrick Holford (right), founder of foodforthebrain.org, the UK’s leading dementia prevention charity, which is running the prevention project together with Dr Tommy Wood, Assistant Professor at the University of Washington.

“By tracking a person’s blood sugar, vitamin B, D and omega-3 status against changes in cognitive function over time, in addition to lifestyle factors such as sleep and physical activity, we can learn what really helps prevent cognitive decline,” says Dr Wood, the principal investigator for the study.

The charity has already tested over 410,000 people with their free Cognitive Function Test at foodforthebrain.org and hopes to enrol a million people, making this the largest’ citizen science’ global prevention initiative.

“Subtle changes in cognition occur at least 30 years before a diagnosis, which is why we screen people online with a free Cognitive Function Test. And there are four simple blood tests that are not only predictive but can help a person understand how to drive down that risk.

I call them the four horsemen of the mental health apocalypse because they also drive depression and ADHD. The incidence of both of these are on the increase,” says Holford.

The four tests, called DRIfT (the Dementia Risk Index Functional Test), carried out using a simple home-test kit and a single pinprick of blood, add further predictive capability and help guide the individual to make diet changes to reduce future risk.

Blood sugar (HbA1c) – Even raised blood sugar levels from age 35, but within ‘reference’ ranges, predict a 15 per cent increased risk of Alzheimer’s disease 35 years later, according to research by Boston University School of Medicine.[1]

This confirms other research from the University of Washington showing an 18% increased risk with raised sugar levels in older people seven years later and a 40% increased risk in those with diabetes.[2]

Even better than your blood sugar level, which varies across the day, is a long-term measure of blood sugar, called HbA1c, used to predict diabetes, which is what this test measures.

B vitamins (Homocysteine) – Low levels of B12, found in animal products, and folate, found in greens, raise blood levels of homocysteine. Raised homocysteine is considered a top marker for dementia risk and is a causative driver of the disease process.[3] Studies lowering homocysteine with B vitamins have more than halved the rate of age-related brain shrinkage.

A Swedish study started in 1968 found that those in the top third of homocysteine scores in their 40s had double the risk for Alzheimer’s almost 35 years later.[4] When homocysteine goes up, memory gets worse, and when it goes down, memory gets better, according to a six-year study in Norway.[5]

About half of all people over 60 have homocysteine levels above 11mcmol/l [6], which is the level associated with increased brain shrinkage. A study in Italy found that those with homocysteine above 15mcmol/l have five times the risk of developing Alzheimer’s compared to those with a level below 10.[7]

Last year, a study in China showed that raised homocysteine increases the risk of cognitive decline by ten times.[8] Homocysteine is easily lowered by supplementing vitamins B6, B12 and folate but at levels higher than achievable from diet because many older people do not absorb B12 well.

Oxford University’s health economist Dr Apostolos Tsiachristas estimates that “Screening for homocysteine in people over 60 in the UK and treating those with raised levels with B vitamins could save the UK economy approximately £60 million per year.”

Omega-3 – Increased intake of omega-3, either from diet or supplements and having a higher omega-3 blood level, is associated with cutting the risk for dementia by a fifth (20%), according to a study of 48 studies involving over 100,000 people.[9]

Supplementing fish oils[10] cuts the risk of dementia by 9%, according to research from the UK BioBank. Being in the top third for omega-3 blood levels, compared to the lowest third, reduced the rate of brain shrinkage in a year by more than two-thirds in those given B vitamins with mild cognitive impairment.[11]

The omega-3 index, which is what the DRIfT test measures, predicts both brain size and cognitive function.[12] This Oxford University research establishes that the brain needs both sufficient B vitamins and omega-3 to stay healthy.

Vitamin D – Having a higher vitamin D above 75nmol/l (25 ng/ml) cuts the risk for Alzheimer’s and dementia by a third.[13] In turn, those with a vitamin D level below 50nmol/l increase their risk for Alzheimer’s and dementia by a third.[14]

Six out of 10 adults in the UK[15] and three out of 10 in the US[16] have a vitamin D level below this. Taking vitamin D supplements may help ward off dementia, according to a 2023 study involving over twelve thousand dementia-free 70+ year olds in the US. Those taking vitamin D supplements had a 40% lower incidence of dementia during a ten-year period. Vitamin D is essential to supplement during the winter months.

These four risk factors, measured in the DRIfT test, are thought to account for over half the modifiable risk for Alzheimer’s disease and dementia.[17] Having an active lifestyle, both physically, socially and intellectually, further reduces risk substantially.

To take the free online Cognitive Function Test, the pinprick DRIfT test, and join the global prevention study, go to www.foodforthebrain.org.

References:

• [1] Zhang X, Tong T, Chang A, Ang TFA, Tao Q, Auerbach S, Devine S, Qiu WQ, Mez J, Massaro J, Lunetta KL, Au R, Farrer LA. Midlife lipid and glucose levels are associated with Alzheimer’s disease. Alzheimers Dement. 2023 Jan;19(1):181-193. doi: 10.1002/alz.12641. Epub 2022 Mar 23. PMID: 35319157; PMCID: PMC10078665.
• [2] P.K. Crane et al., ‘Glucose levels and risk of dementia’, New England Journal of Medicine (2013), vol 369(6):540–548.
• [3] Smith AD, Refsum H, Bottiglieri T, Fenech M, Hooshmand B, McCaddon A, Miller JW, Rosenberg IH, Obeid R. Homocysteine and Dementia: An International Consensus Statement. J Alzheimers Dis. 2018;62(2):561-570. doi: 10.3233/JAD-171042. PMID: 29480200; PMCID: PMC5836397.
• [4] Zylberstein DE, Lissner L, Bjorkelund C, Mehlig K, Thelle DS, Gustafson D, Ostling S, Waern M, Guo X, Skoog I (2011) Midlife homocysteine and late-life dementia in women. A prospective population study. Neurobiol Aging 32, 380-386
• [5] Nurk E, Refsum H, Tell GS, Engedal K, Vollset SE, Ueland PM, Nygaard HA, Smith AD (2005) Plasma total homocysteine and memory in the elderly: The Hordaland Homocysteine study. Ann Neurol 58, 847-857.
• [6] Pfeiffer CM, Osterloh JD, Kennedy-Stephenson J, Picciano MF, Yetley EA, Rader JI, Johnson CL. Trends in circulating concentrations of total homocysteine among US adolescents and adults: findings from the 1991-1994 and 1999-2004 National Health and Nutrition Examination Surveys. Clin Chem. 2008 May;54(5):801-13. doi: 10.1373/clinchem.2007.100214. Epub 2008 Mar 28. PMID: 18375482.
• [7] Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, Porcellini E, Licastro F (2005) Homocysteine and folate as risk factors for dementia and Alzheimer disease. Am J Clin Nutr 82, 636-643.
• [8] Teng Z, Feng J, Liu R, Ji Y, Xu J, Jiang X, Chen H, Dong Y, Meng N, Xiao Y, Xie X and Lv P (2022) Cerebral small vessel disease mediates the association between homocysteine and cognitive function. Front. Aging Neurosci. 14:868777. doi: 10.3389/fnagi.2022.868777
• [9] Wei BZ, Li L, Dong CW, Tan CC; Alzheimer’s Disease Neuroimaging Initiative; Xu W. The Relationship of Omega-3 Fatty Acids with Dementia and Cognitive Decline: Evidence from Perspective Cohort Studies of Supplementation, Dietary Intake, and Blood Markers. Am J Clin Nutr. 2023 Apr 5:S0002-9165(23)46320-4. doi: 10.1016/j.ajcnut.2023.04.001. Epub ahead of print. PMID: 37028557.
• [10] Huang Y, Deng Y, Zhang P, Lin J, Guo D, Yang L, Liu D, Xu B, Huang C and Zhang H (2022) Associations of fish oil supplementation with incident dementia: Evidence from the UK Biobank cohort study.Front. Neurosci. 16:910977.doi: 10.3389/fnins.2022.910977
• [11] Jernerén F, Elshorbagy AK, Oulhaj A, Smith SM, Refsum H, Smith AD. Brain atrophy in cognitively impaired elderly: the importance of long-chain ω-3 fatty acids and B vitamin status in a randomized controlled trial. Am J Clin Nutr. 2015 Jul;102(1):215-21. doi: 10.3945/ajcn.114.103283. Epub 2015 Apr 15. PMID: 25877495.
• [12] Loong, S.; Barnes, S.; Gatto, N.M.; Chowdhury, S.; Lee, G.J. Omega-3 Fatty Acids, Cognition, and Brain Volume in Older Adults. Brain Sci.2023,13,1278. https://doi.org/ 10.3390/brainsci13091278
• [13] https://foodforthebrain.org/the-role-of-vitamin-d-in-reducing-risk-of-alzheimers-diseasewilliam-b-grant-ph-d/
• [14] Chai et al. BMC Neurology (2019) 19:284 https://doi.org/10.1186/s12883-019-1500-6
• [15] Calame W, Street L, Hulshof T. Vitamin D Serum Levels in the UK Population, including a Mathematical Approach to Evaluate the Impact of Vitamin D Fortified Ready-to-Eat Breakfast Cereals: Application of the NDNS Database. Nutrients. 2020 Jun 23;12(6):1868. doi: 10.3390/nu12061868. PMID: 32585847; PMCID: PMC7353432.
• [16] Liu X, Baylin A, Levy PD. Vitamin D deficiency and insufficiency among US adults: prevalence, predictors and clinical implications. Br J Nutr. 2018 Apr;119(8):928-936. Doi: 10.1017/S0007114518000491. PMID: 29644951.
• [17] https://foodforthebrain.org/what-is-the-scientific-basis-of-the-cft-dri-cog-nition/