The battle against Alzheimer’s disease is advancing rapidly, thanks to groundbreaking research from the Icahn School of Medicine at Mount Sinai and other institutions around the world. Where there was once a bleak landscape—where diagnosis came too late and with very limited treatment options—there is now hope for researchers, clinicians, and patients as new drugs and imaging technologies become available. With the advancement of diagnostic tools, the research community has its sights set on an even more ambitious goal: preventing or delaying Alzheimer’s disease before it ever takes hold.

“We need more data from a diverse range of people to fully realize the potential of these biomarkers,” says Dr. Sano. “The general public needs to know about these biomarkers, and how they can make them more powerful by participating in research studies.”

What are blood biomarkers and how are they linked to Alzheimer’s disease?

In the past, detecting Alzheimer’s and related degenerative diseases required invasive procedures, like spinal taps, and was typically reserved for patients already experiencing symptoms of cognitive decline. While these work-ups–or comprehensive tests– measure certain proteins, or biomarkers, that are telltale signs of the disease, they silo brain health from the rest of the body, says Dr. Elahi.

Now, researchers and physicians understand that what is present in the brain can be detected in the rest of the body, including blood, opening up new possibilities for early diagnosis. Key blood biomarkers linked to Alzheimer’s include:

• Hyperphosphorylated tau: One hallmark of Alzheimer’s disease is amyloid beta plaque buildup in the brain, and elevated levels of hyperphosphorylated tau in the blood is predictive of amyloid beta brain accumulation. This biomarker can accelerate the diagnosis and help guide the work-up that lead to treatment decisions.
• Neurofilament light (NfL): This structural protein found in neurons and axons is shed when axons degenerate, and is one of the earliest known biomarkers of brain degeneration for Alzheimer’s and other related dementia disorders. NfL levels can provide valuable insight into the disease’s progression
• Glial fibrillary acidic protein (GFAP): This protein is highly expressed by specialized brain cells called astrocytes. Approved by the Food and Drug Administration as a biomarker for traumatic brain injury, several studies show that levels of GFAP are also elevated in patients with Alzheimer’s disease and related dementias.

“We are learning so much, but we need more participants to help use fine-tune these biomarkers,” says Dr. Sano. “We’re on the cusp of making these tools useful to clinicians and to the broader public.”

How you can help make preventive screening a reality

Participating in Alzheimer’s research is a vital step toward turning these promising biomarkers into reliable tools for prevention. Signing up for an Alzheimer’s disease research center registry is a good start, says Dr. Sano. The team at Mount Sinai will reach out to interested individuals offering various ways to participate.

Diversity in these studies is crucial.  “Different factors, like comorbidities, can influence biomarker levels, and we need to understand these nuances,” says Dr. Elahi. Historically, Alzheimer’s research has been predominantly white-centric, but the disease affects people of all backgrounds. To create effective screening tools, the research community needs participants from a wide range of medical, socioeconomic, gender, age, race, and ethnic backgrounds.

“We need to shift our thinking from treating Alzheimer’s disease to preventing it,” says Dr. Sano. This message is going to be important for people in their 30s, 40s, and 50s, so they can take appropriate steps, such as screening or adjusting lifestyle habits, to reduce or delay the risk.

“New tools, such as blood biomarkers, that push the frontier of early detection will impact what we learn about the causes of disease and eventually revolutionize treatments,” says Dr. Elahi.

If you know someone who has had to stay home because of COVID-19, you’re not alone. Cases of the virus have been rising in New York City.

However, experts say this was expected, as there was a spike in cases last summer. More important, the number of hospitalizations is below the previous spikes that have appeared regularly over the last four years, and nowhere near the highest levels recorded in 2020 and 2022.

“The good news is the peak is not as high,” says Bernard Camins, MD, MSC, Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai and the Medical Director for Infection Prevention for the Mount Sinai Health System.

One thing that’s different right now is that a new vaccine is on the way, and the experts say you should plan to get that as soon as it’s available. The Food and Drug Administration approved the new vaccine on Thursday, August 22, sooner than anticipated. The new vaccine is expected to be available shortly.

Dr. Camins and Judith A. Aberg, MD, Dean of System Operations for Clinical Sciences and Chief of the Division of Infectious Diseases at Icahn Mount Sinai, who have been tracking the virus since it arrived in New York City in March of 2020, offer three key takeaways about COVID-19 and what you need to do to stay healthy.

Another summer surge, but less so: Experts believe cases tend to rise in the summer as more people get out and travel around, exposing more people to new variants. In addition, lots of people still tend to gather indoors during the summer.

Hospitalizations in New York, one of the key measures of the virus, have been rising through June and July, but they began to decline in late July, according to the New York City Department of Health and Mental Hygiene.

Health authorities have stopped tracking the number of individual cases of COVID-19 because health care providers are no longer reporting them and because so many people are testing themselves and so positive results are not officially recorded. Also, the government has stopped giving out free testing kits, so that’s discouraged some from testing. (Another measure of the growing number of cases has been the presence of the virus in wastewater, which is tracked by health authorities.)

Your best defense against a COVID-19 infection remains the same: Keep up to date with your vaccinations, consider taking steps to limit your exposure to large indoor crowds, wear a well-fitting mask at public gatherings or in tight spaces such as an airplane or subway, and talk with your health care provider if you are feeling sick.

The new variant: The latest dominant variants of the virus causing COVID-19 in New York, known as KP.3 and LB.1, do not seem to be any more worrisome than others that came before it, and existing treatments work well against it.

“We will continue to see more variants as the virus that causes COVID-19 mutates,” says Dr. Aberg, who has been seeing more cases among her patients and writing more prescriptions for antiviral medication. “You just have to accept there is always going to be a new variant.”

The time for a new vaccine is approaching: In fact, the rise of new variants is why it is important for everyone six months and older to get the new vaccine once it is available, experts say. COVID-19 vaccines typically provide protection for up to 20 weeks before their effectiveness begins to decline. Data continue to show the importance of vaccination to protect against severe outcomes of COVID-19, including hospitalization and death, according to the CDC.

To explain to her patients why getting the new vaccine is important, Dr. Aberg will often draw a simple diagram. The diagram looks like the branches of a large tree spreading out. What’s important is that the recent variants all extend off the same main branch, so a vaccine that is effective against the variant on the preceding branch will be effective against the variants that follow that branch. The latest variants stem from a different branch than the variants in 2023 that were dominant when the 2023 formulation of the COVID-19 vaccine was developed. So the vaccine you received last year will not be as effective against the most recent variants.

One other point to consider if you plan to get the new vaccine in the fall: After you get the vaccine, it takes about two weeks for the antibodies to build up in your system. So if are getting the vaccine because you are planning to take a trip or attend a large family gathering, be sure to get it at least two weeks in advance if possible.