If Alzheimer’s disease runs in your family, it is hard not to wonder about your own future.
Maybe you watched a parent or grandparent struggle with memory loss. Maybe you have noticed subtle changes in yourself and wondered whether they mean anything. Or maybe you feel completely well but want to know if there is anything you can do now to better protect your brain as you age.
For a long time, that was a difficult place to be. We knew Alzheimer’s-related changes could begin years before obvious symptoms appeared, but looking for those changes often required more involved testing. That is beginning to change.
One of the blood biomarkers getting a lot of attention right now is called p-tau217. It gives us another way to look for biological changes associated with Alzheimer’s disease, and it can be measured with a simple blood draw.
That is what makes this so interesting to me. Not because one blood test can predict your future. It can’t. But because we may be able to identify important changes earlier and use that information to ask better questions about someone’s brain health before significant memory problems develop. And that leads to what I think is the more important question:
If we find something early, what do we actually do with that information?
An elevated p-tau217 result does not mean you are destined to develop Alzheimer’s dementia. It is one piece of information that can help us better understand what may be happening in the brain and whether additional evaluation makes sense.
So, What Exactly Is p-tau217?
The name sounds complicated, but the basic idea is actually fairly simple. Two proteins we talk about often in Alzheimer’s disease are amyloid and tau. Amyloid can begin building up in the brain and forming plaques. Tau is a protein that normally helps support the structure of our brain cells.
As Alzheimer’s-related changes develop, tau can begin changing too. One of those changes is called phosphorylation. You do not need to remember that word. What matters is that scientists can now measure specific forms of this altered tau in the blood. One of these biomarkers is p-tau217, which has emerged as an important tool for identifying Alzheimer’s-related amyloid pathology.
And that is part of what makes this test so interesting. In the past, looking for these changes often required more involved testing, such as an amyloid PET scan or testing cerebrospinal fluid. Today, a blood test can give us another, much less invasive way to gather important information about what may be happening in the brain.
Blood testing hasn’t completely replaced PET scans or spinal fluid testing, and there are still times when additional testing may be needed. But it brings us to a much more important question:
What does it actually mean if my p-tau217 is elevated?
What Does an Elevated p-tau217 Result Mean?
This is where the conversation gets more personal. If your p-tau217 is elevated, what does that actually mean for you?
In simple terms, a higher p-tau217 level can indicate that Alzheimer’s-related biological changes are more likely to be occurring in the brain. But an elevated result is not the same thing as being diagnosed with Alzheimer’s dementia. It also cannot tell us with certainty whether you will develop dementia or when symptoms might appear.
That distinction is important because these biological changes can be present before someone has noticeable problems with memory or thinking. A p-tau217 result gives us useful information, but it does not tell us the entire story.
Results also aren’t always simply positive or negative. Depending on the test, there may be an intermediate range where additional evaluation is needed. This is one reason I don’t like looking at a biomarker in isolation.
A biomarker is a piece of information. It isn’t your destiny.
If p-tau217 is elevated, I want to know what else is going on. Are there changes in memory or thinking? Is there a family history of Alzheimer’s disease? Are there other risk factors we should be paying attention to?
Those questions help us decide what the result means for that individual and, more importantly, what we may want to do next.
If My p-tau217 Is High, Is There Anything I Can Do?
This is usually the next question. If we can identify these changes earlier, is there anything we can actually do about them?
Yes, there is something we can do. The encouraging answer is that there are many aspects of our health that we can influence. We know that lifestyle and other modifiable risk factors can play an important role in long-term brain health and our risk for cognitive decline and dementia.
That is why I want to look at things such as blood sugar, cardiovascular health, sleep, nutrition, physical activity, and underlying toxins and/or infections. Depending on the person, genetics, cognitive testing and other biomarkers may also be helpful. The goal is to identify risks we may actually be able to address.
Exercise is a great example. Regular physical activity has been associated with better brain health and a lower risk of cognitive decline and dementia. There is even emerging research showing an association between greater physical activity and lower p-tau217 levels. The research is still evolving, but the connection is encouraging.
This is why I believe earlier information can be so valuable. I think of an elevated result as a call to action, not a prediction of your future. We can’t change every risk factor, but we can focus on the ones we may be able to address. Rather than being afraid of what a biomarker might mean for the future, we can use that information to make better decisions about our health today.
Should You Get a p-tau217 Test?
With a blood test like this available, it’s natural to wonder whether everyone should be getting one, especially if Alzheimer’s disease runs in your family.
Right now, p-tau217 testing is most established for people who are experiencing cognitive changes and are being evaluated for possible Alzheimer’s disease. Routine screening is not currently recommended for every healthy adult, and there isn’t an established age when everyone should begin testing.
But I don’t think that means we should wait until significant memory problems develop before we start thinking about brain health. If Alzheimer’s runs in your family, you’ve noticed changes in your memory or thinking, or you simply want to be more proactive as you age, it may be worth talking with a physician about what testing makes sense for you.
If you are interested in having your p-tau217 tested, I can help determine whether it makes sense for you and order the appropriate testing when indicated. Just as importantly, we can talk about what the results mean and what we may want to do with that information.
The science around p-tau217 is moving quickly, particularly when it comes to how these biomarkers may eventually be used before symptoms develop. For now, I think the more useful question is not simply, “Should I get the test?”
It’s “What would I do with the information once I have it?”
Looking at the Bigger Picture of Your Brain Health
For me, the value of testing is not simply finding out whether a number is high or low. It is understanding what that result means for the person sitting in front of me and how we can use that information moving forward.
This is one reason I work with PreCODE, a prevention-focused approach for people who want to better understand their cognitive health and individual risk factors. It allows us to look beyond one test result and put the different pieces together to create a plan that makes sense for that individual.
My goal is never to give someone a p-tau217 result and leave them wondering what it means. I want them to understand the information, know what we may need to look at next, and feel like they have a thoughtful path forward.
Concerned About Your Brain Health?
If you are concerned about your memory, Alzheimer’s risk or simply want to take a more proactive approach to your brain health, I can help you better understand your individual risk and what your next steps may look like.
Learn more about my PreCODE brain-health approach or request a consultation to get started.
Dr. Cheri Dersam
Dr. Cheri Dersam is a board-certified Emergency Medicine physician with advanced training in Integrative and Functional Medicine and is a Bredesen Protocol Certified Practitioner. She specializes in cognitive and brain health, metabolic health, healthy aging, and complex chronic health concerns. She has also been recognized multiple times as a Phoenix Magazine Top Doctor.