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A study of 186 attendees at a brain health service in Monza, Italy, found that many people reporting cognitive changes despite normal standard test performance had modifiable dementia risk factors. Among participants with subjective cognitive decline, elevated blood p-Tau217 was associated with signs of neurodegeneration; around 60% of those who received results said they felt more motivated to change their lifestyle.
A study of 186 people attending a brain health service in Monza, Italy, found a high burden of modifiable dementia risk factors among participants who reported cognitive changes but performed normally on standard tests. Researchers also found that elevated blood p-Tau217 was associated with early signs of neurodegeneration in some people with subjective cognitive decline, and about 60% of participants who received their results reported greater motivation to make lifestyle changes.
The study, published in Neurological Sciences, included 132 attendees classified as having subjective cognitive decline, or SCD. People in this group notice changes in memory or thinking while continuing to perform within normal ranges on standard cognitive tests. The researchers compared them with attendees classified as having mild cognitive impairment, functional cognitive decline or no significant cognitive impairment despite concern.
For SCD participants with blood test results, the researchers grouped p-Tau217 levels as above or below a study threshold of 0.15 picograms per milliliter. The biomarker is associated with Alzheimer’s-related changes. Elevated levels were linked in the study to signs of neurodegeneration; that finding does not establish that every participant with a high result will develop dementia or that a blood test alone can provide an individual diagnosis.
At a follow-up visit, participants were given information about their p-Tau217 results and APOE genotype, along with an estimate of dementia risk and recommendations for prevention. They completed online questionnaires one week later. The report says about 60% of those who underwent disclosure reported greater motivation for lifestyle changes. This was a self-reported response, not evidence that participants changed their habits or reduced their future dementia risk.
Memory Concerns Beyond Test Scores
The findings highlight a gap between a person’s experience of memory or thinking changes and what a standard cognitive test captures at a single appointment. Normal test performance does not rule out health risks, while concern alone does not establish that a person has Alzheimer’s disease or another neurodegenerative condition. The study suggests that clinicians may need to consider risk factors and other assessments alongside test scores.
Its results also touch on a practical question for prevention services: whether sharing biomarker and risk information can help people engage with lifestyle recommendations. The reported increase in motivation offers an early indication of how participants reacted to disclosure, but the study did not show whether that motivation lasted or led to measurable health changes. The results support further evaluation of this approach rather than proving it prevents dementia.
For readers, the distinction matters because memory concerns can have varied causes and a biomarker result can be difficult to interpret without clinical context. The study describes one service’s assessment and disclosure process; it does not establish that everyone with subjective memory concerns should receive blood biomarker testing.
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How Brain Health Services Assess Risk
Subjective cognitive decline is common and varied. Some people with SCD may have early biological changes linked to Alzheimer’s, but concerns can also be associated with other neurological or non-neurological factors. The study report notes that previous research has estimated that, in some settings, up to one-third of people with SCD may have preclinical Alzheimer’s disease. That estimate is not a finding about the Monza participants and may differ by population and setting.
The Monza service is designed around prevention and risk assessment, unlike a conventional memory clinic whose central role is diagnosing and treating cognitive disorders. Its assessments can include cognitive screening, blood biomarkers, APOE genotyping and brain imaging. The study examined consecutive attendees in routine service conditions, rather than a population-wide sample, so its findings may not represent all people with memory concerns.
Guidance on testing people who remain cognitively unimpaired is unsettled. The report says the Alzheimer’s Association’s workgroup recommends against diagnostic biomarker testing in cognitively unimpaired people outside observational or therapeutic research. The International Working Group generally treats biomarker-positive people without cognitive impairment as being at risk, rather than as having Alzheimer’s disease, while allowing non-diagnostic pathways for risk estimation and reduction in people with SCD.
“About 60% of participants who underwent disclosure reported greater motivation for lifestyle changes.”
— The study authors, as summarized in the News-Medical report
dementia risk assessment blood test
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Limits of Biomarker Disclosure Findings
The study was a real-world analysis of 186 attendees at one service, including 132 with SCD. The report describes some comparisons between attendee groups as exploratory because of the small sample size. The findings cannot establish how common the same risk patterns are across the wider population or whether they apply equally in other clinical settings.
It is also unclear whether increased motivation after receiving results translated into sustained lifestyle changes or altered dementia risk. The available report does not give enough detail to assess the long-term outcomes of disclosure. Nor does the association between elevated p-Tau217 and neurodegeneration establish an individual’s future diagnosis or prognosis. How biomarker results should be communicated to people without measurable impairment remains an area of debate.
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Longer Follow-Up Needed
The study’s one-week questionnaire captured participants’ immediate reported response to risk disclosure. Longer follow-up would be needed to determine whether motivation leads to lasting changes and whether those changes affect health outcomes. Larger studies across multiple services could also clarify how well these findings apply beyond the Monza attendees.
For now, the report describes an approach that combines cognitive assessment, risk factors and biomarkers rather than relying on test scores alone. It does not provide a new universal testing recommendation. Decisions about memory concerns or biomarker tests require clinical context, and the study does not settle when testing or disclosure is appropriate for people whose cognitive tests remain normal.
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Key Questions
What is subjective cognitive decline?
Subjective cognitive decline means a person notices changes in memory or thinking, even though standard cognitive testing does not show impairment. It can have different causes and does not by itself mean that a person has dementia.
What did the Monza study find about p-Tau217?
Among SCD participants with available blood tests, p-Tau217 levels at or above 0.15 pg/mL were linked to signs of neurodegeneration in the study. The association does not mean that every person with an elevated result will develop dementia.
Did participants change their lifestyles after receiving results?
About 60% reported greater motivation to make lifestyle changes after disclosure. The report describes self-reported motivation one week later; it does not establish that participants made lasting changes or lowered their dementia risk.
Does the study recommend biomarker testing for everyone worried about memory?
No. The study examined attendees at one brain health service and does not establish a universal testing recommendation. Guidance on biomarker testing for people who remain cognitively unimpaired is debated, and results require clinical interpretation.
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