WASHINGTON — Lawmakers in Congress are considering bipartisan legislation that would expand Medicare coverage to include blood tests capable of detecting Alzheimer’s disease years before symptoms surface, as medical researchers report rapid progress on new testing technologies.
The measure, titled the Alzheimer’s Screening and Prevention Act, or ASAP Act, aims to make screening for Alzheimer’s routine under Medicare in the same manner patients are checked for cancer and cholesterol, according to an account published by InForum. Advocates and health care workers are pushing federal lawmakers to advance the legislation before the end of the year.
Advancements in Early Detection
Blood-based diagnostic options have expanded significantly in recent years. The U.S. Food and Drug Administration cleared a blood test used to diagnose Alzheimer’s disease, and multiple commercial entities have focused on developing assays designed to detect amyloid plaques and phosphorylated tau proteins, Psychiatric Times reported.
New clinical research presented at the Alzheimer’s Association International Conference in London demonstrated that a simple blood test can detect biomarkers for Alzheimer’s in asymptomatic individuals a decade or more before cognitive symptoms manifest, InForum reported. Identifying markers early allows individuals to implement lifestyle adjustments aimed at delaying symptom onset, prepare personal plans, and seek medical treatments at the stages when therapies provide the highest efficacy.
Emerging RNA Diagnostic Research
Beyond traditional tests centered on amyloid and tau proteins, investigators are studying alternative cellular targets to catch neurodegenerative disease even earlier. Navneet Dogra, an assistant professor at the Icahn School of Medicine at Mount Sinai, is leading research examining the RNA trajectory between DNA and protein, according to Psychiatric Times.
Dogra’s research hypothesizes that shifts in RNA may occur before physical pathology develops, potentially offering a way to spot dementia a step ahead of disease progression. The strategy relies on collecting a standard blood draw, isolating extracellular vesicles and particles, and extracting the RNA to assess what is happening inside the brain.
The eventual goal of the Mount Sinai team is creating a polymerase chain reaction assay, similar to PCR tests widely deployed during the COVID-19 pandemic, that targets specific sets of RNAs that alter consistently with aging or neurodegenerative illness. The diagnostic process from blood draw to clinical result could take four to five hours, Dogra noted to Psychiatric Times.
“Taking someone’s blood, extracting a set of extracellular vesicles and particles, and then looking at their RNA and understanding what is going on in the brain,” Dogra said in describing the concept to Psychiatric Times.
Future Applications and Legislative Outlook
The findings from the extracellular vesicle study remain preliminary, having evaluated a small cohort of 20 to 25 patients, and Dogra emphasized that additional research is necessary. Scientists believe the particle-tracking approach might also eventually offer diagnostic clarity for psychiatric illnesses, including depression and schizophrenia, where definitive biological tests do not currently exist.
Tracking these biological markers over extended periods could also help physicians determine whether specific therapeutic regimens are effectively slowing cognitive decline, Dogra told Psychiatric Times.
Back on Capitol Hill, supporters are urging federal lawmakers to clear the ASAP Act before the legislative session concludes. It remains to be seen whether congressional leadership will schedule the bill for a final floor vote in both chambers before the year ends.
