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2022 Alzheimer's Association Clinician Scientist Fellowship (AACSF)

Disclosing Dementia Risk Based on Plasma Phosphorylated Tau: A Pilot Study

Can a new educational program help reduce the stress of learning one’s potential risk for Alzheimer’s?

Corey Bolton, Psy.D.
Vanderbilt University Medical Center
Nashville, TN - United States


Several emerging methods allow for detection of early brain changes associated with Alzheimer’s in the blood and cerebrospinal fluid (CSF, the biological fluid surrounding the brain and spinal cord). These methods require measuring specific biological markers, or “biomarkers,” (such as the level of tau protein, which accumulates to form tau tangles, a hallmark brain change observed in Alzheimer’s as well as other brain diseases).

Tau is normally changed by the addition of a molecule known as phosphate to specific parts of the tau protein. In Alzheimer’s and other brain diseases, tau becomes excessively phosphorylated (high levels of phosphate added to the tau protein) and then clumps together to form tangles. These tangles have been shown to be associated with brain cell damage and death.

There are many forms of phosphorylated tau (or “pTau”) which differ by the location on the tau protein where the phosphate molecule is added. Increases in pTau can be detected before other brain changes, and may help distinguish those with Alzheimer’s from those with other brain diseases. However, it is important to understand safe and effective methods for disclosing these pTau test results.

Research Plan

Dr. Corey Bolton and colleagues will develop and test educational materials that can assist in disclosing pTau test results. This material will include information about how the blood test works and what the results may say about one’s risk for Alzheimer’s. The researchers will then study the effect of their educational material’s effectiveness in sharing information with the two groups of individuals with mild cognitive impairment (a condition of subtle memory loss that may precede dementia). The first group will be asked to judge how easy the material is to read and understand. Results from this first test will be used to refine and clarify the educational material. The second group will have their blood drawn for the pTau detection test, and results will be disclosed to them using the newly developed and refined educational materials. The researchers will then use psychological tests to identify the mental impact of the disclosure at two time points: immediately after the disclosure and six months later. 


Dr. Bolton’s project could shed new light on how individuals process the knowledge of their personal risk for dementia. It could also identify a cost-effective method for minimizing psychological harm resulting from a risk disclosure.

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