But so much can now be done so that virtually all of us may avoid these dire predictions:

• For the first time, blood tests are available that will allow all of us to “see it coming” so that we can identify early brain aging changes and undergo successful treatment virtually every time, thus avoiding cognitive decline. These blood tests reflect ongoing brain chemistry, so they offer very similar information to what one would receive from a spinal tap or a PET scan, without being invasive like a spinal tap or as expensive as a PET scan. These also allow us to follow our progress over years, so that each of us can optimize a personalized protocol to support our best brain health.

• These tests include p-tau 217, NfL (neurofilament light), GFAP (glial fibrillary acidic protein), and Abeta 42:40 ratio, and they provide complementary types of information. The p-tau 217 test detects an altered form of the brain protein tau—normally, tau stabilizes brain cell connections, but when we are exposed to infectious agents (such as the Herpes from cold sores, for example), the tau is altered biochemically, becoming p-tau, which changes its job from stabilizing connections to fighting infections. There are multiple sites for this alteration, but the one at 217 is most closely associated with Alzheimer’s disease, so it’s a good idea for all of us who are over 35 to know where we stand (I just had mine checked a couple of months ago). If you are 60 or under, you only need to check every five years or so, and after 60, it's a good idea to check every two years or so. 

• GFAP gives us complementary information, disclosing ongoing brain inflammation and repair from any cause, and NfL reveals damage to the brain’s neurons, whether from an auto accident or other head trauma or any neurodegenerative condition. These all can be checked by a very sensitive test developed by Neurocode (getabrainscan.com). In addition, the Abeta 42:40 ratio reflects brain changes associated with Alzheimer’s. It is an early marker, but the magnitude of the change is far less robust than with p-tau 217.