SubscriberWrites: Urinary formic acid potential biomarker for early diagnosis of Alzheimer’s disease, study says

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The researchers who conducted the study at the Sixth People’s Hospital had previously reported on a correlation between urinary formaldehyde levels and cognitive decline, and a potential for urinary biomarkers to help in early and inexpensive diagnosis of Alzheimer’s disease in comparison to the known plasma biomarkers like Aβ and Tau, which are time – consuming and invasive.

The study aimed to explore the relationship between urinary formic acid levels and cognitive changes throughout the progression of the disease, and the relationship between urinary formic acid and the apolipoprotein E (APOE) allele ε4, was further analyzed. The APOE ε4 allele is the most important genetic risk factor for Alzheimer’s disease after age 65, and is associated with various pathological changes and cognitive impairment in the disease course.

574 participants underwent cognitive function tests and neuropsychology assessments by trained staff in a period of 1.5 years. According to the clinical diagnosis obtained, the participants were divided into groups with normal cognitive function, subjective cognitive decline (early stage of the disease), mild cognitive impairment, and Alzheimer’s disease (AD), respectively.

Morning urine samples were collected from participants in the same week after the neuropsychological test, and the levels of formic acid and formaldehyde in collected urine samples were determined according to standard protocol. Genomic DNA was extracted from whole blood samples collected from the participants to genotype for Apolipoprotein E (APOE).

The study reported some noteworthy findings. Urinary formic acid levels were higher in groups with  impaired cognition in comparison to those with normal cognitive function. The results also established higher levels of urinary formic acid in participants with lower cognitive test scores.  Urinary formaldehyde levels were found to be higher in the APOE ε4+ subgroup as compared to the APOE ε4− subgroup. Most importantly, there was a significant increase in urinary formic acid in the ‘subjective cognitive decline’ diagnostic group, meaning that urinary formic acid can be used for the early diagnosis of Alzheimer’s disease.

Known to be the most common form of dementia, Alzheimer’s disease is clinically described by progressive cognitive an behavioural disorders. It usually presents first with subjective (patient – described) cognitive decline and eventually progresses to mild cognitive impairment, which is the stage before the irreversible dementia stage of Alzheimer’s disease. This is the ‘golden window’ for intervention and treatment.

Hence large scale screening is necessary, and economical tools like urinary biomarkers can be beneficial in early diagnosis and treatment of Alzheimer’s disease.

Reference: https://www.frontiersin.org/articles/10.3389/fnagi.2022.1046066/full

Also read: It’s World Alzheimer’s Day: What you need to know about the disease that damages the brain

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