The simple blood test that can predict Alzheimer's decline

Alzheimer 's decline could be predicted with a simple blood test already offered to those at risk of type 2 diabetes.
The disease is the most common type of dementia, with symptoms including confusion, speech and language issues, problems with moving around and behaviour changes.
Around a million people in the UK are living with dementia, but that figure is projected to rise to 1.4 million by 2040, Alzheimer's UK warns.
There is currently no cure for the disease nor any definitive way to predict how quickly it will progress, only medicines to help relieve some of the symptoms.
However, research presented at the European Academy of Neurology (EAN) Congress 2025 suggests a blood test used to detect insulin resistance could also identify patients at a high risk of cognitive decline.
Neurologists at the University of Brescia, in Italy, analysed data from 315 non-diabetic patients with cognitive deficits – that included 200 people with Alzheimer's disease.
All participants were tested for insulin resistance using the triglyceride-glucose (TyG) index – a low-cost, widely available marker calculated from standard blood test. They were then followed up three years later.
Participants were divided into groups of varying cognitive impairment and also separated according to their insulin resistance score.
Among those with mild cognitive impairment due to Alzheimer's, individuals with the highest TyG scores declined four times faster than those with lower TyG levels – but this link was not seen in the group with cognitive impairment not caused by Alzheimer's.
'Once mild cognitive impairment is diagnosed, families always ask how fast it will progress,' said lead investigator Dr Bianca Gumina.
'Our data show that a simple metabolic marker available in every hospital laboratory can help identify more vulnerable subjects who may be suitable candidates for targeted therapy or specific intervention strategies.'
It's believed insulin resistance impairs glucose uptake in the brain, which means it is less active.
This can lead to increased inflammation in the brain disrupting the blood-brain barrier and contributing to amyloid build-up – a protein that can form toxic plaques in the brain - all of which are linked with the progression of Alzheimer's disease.
While inflammation is the body's defence mechanism which responds to damage and infection to keep us healthy, too much of a good thing can have consequences, Alzheimer's Research explains.
When these toxic proteins build up in people with Alzheimer's, the brain fights back with an inflammatory response to keep the damage at bay. But this is thought to cause more damage.
'We were surprised to see the effect only in the Alzheimer's spectrum and not in other neurodegenerative diseases', Dr Gumina noted.
She suggested it highlights that there is a 'disease-specific vulnerability' to insulin resistance and interventions could change the trajectory of the disease.
Researchers also found high insulin resistance was associated with blood–brain barrier disruption and cardiovascular risk factors, but these were not associated with increased risk of Alzheimer's progression.
It's hoped these findings could help detect Alzheimer's patients who are at a high-risk of cognitive decline early and enrol them in more targeted clinical trials – such as anti-amyloid trials.
This blood test could also be used to make timely interventions to improve their insulin sensitivity.
'If targeting metabolism can delay progression, we will have a readily modifiable target that works alongside emerging disease-modifying drugs', concluded Dr Gumina.
The researchers are currently investigating whether levels of insulin resistance also track with neuroimaging biomarkers- brain scans which indicate the structure, function and chemistry of the organ as well as diagnosing neurological conditions.

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