Lay summary
Blood biomarkers of Alzheimer’s pathology offer a transformative tool for diagnosis and prognosis of New Zealand's most common cause of dementia mate wareware (dementia). This project will address the most pressing challenges associated with their emergence. Firstly, we will determine how to integrate a reliable, scalable and affordable platform for the most promising blood diagnostic marker, p-tau217, into New Zealand's health system. We will analyse its performance against gold standard criteria in existing and prospectively collected New Zealand data, and determine appropriate parameters for different clinical situations via health economic analysis. Secondly, we will establish crucial prognostic markers to integrate with p-tau217 by determining the patterns of change in microRNA - a novel marker of Alzheimer’s processes - across the full disease spectrum by studying presymptomatic and symptomatic people with genetic Alzheimers. This will involve establishing a New Zealand site of the international Dominantly Inherited Alzheimer Network Observational study at the University of Otago. Overall, the project will translate directly into efficient, equitable and future-proofed diagnostic pathways as New Zealand enters a new era of Alzheimer's management.