Blood Biomarker Challenge: If we can fix dementia diagnosis, we open the door for a cure

Back in May, we announced that – alongside Alzheimer’s Society and the National Institute for Health and Care Research – we’d been awarded £5m by the Peoples Postcode Lottery Dream Fund, for a project which will help revolutionise dementia diagnosis in the UK.

Our Blood Biomarker challenge will pilot the implementation of new blood tests in the NHS that can diagnose different forms of dementia, such as Alzheimer’s disease, earlier and more accurately than current methods.

We thought we’d take a look at why we need to fix diagnosis, and what’s been happening since the Spring as we’ve worked with our partners to get this project off the ground.

Why we need to change the dial on diagnosis

Right now, we know that getting an accurate diagnosis takes far too long, with people waiting a year, on average, to see a clinician. And for people with young-onset dementia, it can take as long as four years.

Sadly the problems don’t end there. Coupled with long wait times to see a specialist, the diagnostic tests currently available such as brain scans and lumbar punctures, are time-consuming, uncomfortable, and are not uniformly available to dementia services around the UK.

Looking to the future, there are even more reasons why it’s important to improve the way diseases like Alzheimer’s are diagnosed. Two treatments – lecanemab and donanemab – are finally on the horizon for people with early Alzheimer’s disease. Regulators are now set to decide if lecanemab will be available in the UK as early as next year. Preparing the NHS to make sure these drugs are available to all those who could benefit is now key – and that means accurately diagnosing people at the earliest stages.

Our Blood Biomarker Challenge

Current figures estimate that more than a third of people over 65 who are living with dementia in England go undiagnosed. This highlights an urgent need for the NHS to improve how it diagnoses people with symptoms of dementia.

And introducing a blood test could be a crucial part of that evolution. We have seen significant progress in the in the past year, with research continuing to confirm the promise of blood-based tests for Alzheimer’s disease, and some commercial tests even moving from trials into clinics in some parts of the world.

But there are still unknowns. Although there are many different tests in development, we need to find out which specific types of tests are best at identifying Alzheimer’s disease, and how they will work in practice in the UK’s health service.

However, their promise is clear.

It could mean that when someone is referred to a clinic for diagnosis within the NHS, they will have rapid access to a simple, non-invasive, and inexpensive blood test, receiving the result within weeks. Although more specialist diagnostic tests might be needed to confirm blood test results, ultimately this will open the door to people getting an earlier and more accurate diagnosis than what’s currently available. Diagnosing Alzheimer’s disease at its earliest stages would also allow people time to put in place support and care, take part in clinical trials and to access new treatments when they arrive.

Our Blood Biomarker Challenge will produce the clinical and economic data needed to bring blood tests to people with dementia as quickly as possible. The award will be given to a research project that will trial the use of blood tests in memory clinics. Researchers will be able to see how the test works outside of a controlled lab setting, and how effective it is for a wide range of people from diverse backgrounds who may have other health conditions.

Dr Jorge Gomez-Magenti, Alzheimer’s Research UK’s Head of Strategy & Impact, has been closely involved in the project since the start. “It’s been incredibly exciting to see this project grow from the very beginning, where we spotted an opportunity for research that could make a big difference, and now getting to the point of delivering an initiative that aims to make blood tests a reality in the UK,” he says.

Watch this space

Applications for the project are now closed and are being reviewed by an independent panel of international experts who will ensure that the winning team meets the criteria of the funding call (see below).

The review panel will discuss the applications and decide on the project that will receive the award.

We will be announcing the successful research team in January 2024, and our policy and communications teams at Alzheimer’s Research UK will work closely with the Alzheimer’s Society throughout the duration of the project.

“This has been a huge team effort and together we have succeeded in putting together a diverse panel of reviewers, leading scientists and clinicians who bring their significant expertise to the review process,” says Gomez Magenti. “The panel includes experts in blood biomarker research, the diagnosis pathway in the UK, health economics, as well as people affected by dementia.”

Many of the researchers who work in biomarker development in the UK are likely have worked with each other previously, so it’s been vital to ensure the review panel is independent. As we’ve seen with other diseases, early diagnosis can make the biggest difference. We hope to see the same for the diseases that cause dementia, and we’ll be excited to announce the successful project applicants next year.

Our independent review panel:

Panellists from the field of biomarker research for dementia and other neurodegenerative disease include:

Prof Michael Schöll, Professor of Molecular Medicine at University of Gothenburg and Principal Research Fellow at University College London. Professor Schöll’s research group focuses on using imaging techniques and biomarkers to enable earlier disease diagnosis.

Dr Marta del Campo has worked on several projects related to the discovery of new biomarkers and as director of the BarcelonaBeta Brain Research Centre Fluid Biomarkers Platform means she will oversee the beginning of the biomarker development process to the point of implementation into clinical practice.

Dr Inge Verberk, has continued to build on the work she carried out for her PhD at Amsterdam VUmc, where she is now a research associate working to implement the use of blood biomarkers in research settings, in particular clinical trials.

Dr Aitana Sogorb Esteve is an emerging leader at the UK Dementia Research institute at University College London. In her Race Against Dementia fellowship project, Dr Sogorb Esteve is working on developing fluid biomarkers for a rarer for of dementia know as Frontotemporal dementia.

We have also included panellists that can share insights from other research disciplines, such as Dr Eline Willemse, who works in the area of fluid biomarkers for Multiple Sclerosis at the University of Basel.

Founder of Aries Biotechnologies, Dr Angela Boutte also joins the panel, she brings her expertise from her background in molecular neuroscience coupled with her current role founder of a biotech company which specialises in biomarker analysis.

GRAIL is a healthcare company that uses new technologies to develop ways of detecting cancer early. Sara Hiom is vice president at GRAIL and works in the areas of NHS Implementation and external affairs. This involves working with health departments and other stakeholders to bring this technology to healthcare providers.

As the Biomarker Challenge aims to also the economic as well as clinical data needed to bring blood tests to people with dementia as quickly as possible. The review panel also includes representatives from the area of health economics:

Dr Sara Twaddle, Honorary Professor at the University of Glasgow, is a health economist and health services researcher. As former Director of Evidence at Healthcare Improvement Scotland, Dr Twaddle has been responsible for implementing healthcare initiatives in the public health service.  Professor of Health and Social Care at the University of Essex, Prof Fay Crawford is a health services researcher who has focused on healthcare interventions while keeping public and patient involvement at the forefront of her work.

Dr Samuel Merriel brings insight from the area of detection and prevention of cancer. As a GP and clinical lecture at the University of Manchester, he has both clinical experience but having completed a PhD studying the potential impact of MRI as a diagnostic test for prostate cancer within primary care, understands the practicalities of implementing new diagnostic tests.

Professor Paul McCrone has a background in economics, specialising in healthcare economics. His research interests at the University of Greenwich include evaluating healthcare costs.

Also involved in the review panel process are advisors with a background in clinical pathways and access inequalities. It is key to have input from those who understand the challenges that the clinical landscape faces from an individual to an organisational level.

Ruth Boaden works as an independent advisor on Evaluation to the Greater Manchester Health and Social Care Partnership. Here she supports and evaluates health and social care programmes across greater Manchester localities. She also holds the title of Honorary Professor at Alliance Manchester Business School. While Vivek Pattan, Consultant old age psychiatrist at NHS Forth Valley brings his expertise as National Clinical Lead for Dementia at Health Improvement Scotland.

Moise Roche is a final year PhD student at UCL who is working to improve experience and outcomes for Black families living with dementia. He is exploring how people from different cultures and ethnicities experience health care services and how a framework can be developed to make dementia care more inclusive. Dr Hari Subramaniam is a consultant Psychiatrist at the Leicester Hospitals and Honorary Senior Lecturer at the University of Leicester. During his career he has specialised in assessing memory problems and mental health.