Blood tests analyzing specific plasma proteins can now diagnose Alzheimer's disease with 90 percent accuracy, Greek neurology professor Magda Tsolaki told the national news agency. Addressing key modifiable risk factors could also reduce expected global dementia cases by 45 percent by 2050, while newly approved progression-slowing drugs remain largely out of reach for European patients due to high costs.
Tsolaki, an emerita professor of neurology at Aristotle University of Thessaloniki and president of the Panhellenic Federation of Alzheimer's Disease and Related Disorders, outlined the latest developments in neurodegenerative care to the Athens-Macedonian News Agency. Her comments came ahead of her public lecture on new approaches to dementia diagnosis, prevention, and treatment at the Museum of Byzantine Culture in Thessaloniki at 19:00 today.
Blood plasma protein testing and diagnostic procedures
Recent diagnostic advancements rely on measuring specific biomarkers in blood plasma, notably phosphorylated tau-217, known as p-tau217, and beta-amyloid 1-42. Tsolaki explained that by examining these two proteins in blood plasma, medical professionals can establish an Alzheimer's disease diagnosis with 90 percent accuracy. She noted that a negative test result effectively rules out Alzheimer's disease, allowing clinicians to redirect diagnostic investigations toward alternative forms of dementia.
The blood tests do not replace the full diagnostic evaluation required for cognitive disorders. Tsolaki clarified that a comprehensive diagnosis continues to rely on clinical examinations, formal neuropsychological evaluations, specialized blood panels, and magnetic resonance imaging scans. Physicians analyze the complete battery of diagnostic results before confirming a final diagnosis and tailoring a treatment strategy for the patient.
To widen patient access to these tools, the Panhellenic Federation of Alzheimer's Disease and Related Disorders issued a formal resolution requesting free public provision of the new diagnostic tests. At present, the combined diagnostic panel costs €485 per patient. This total includes €230 for analyzing blood plasma proteins, €220 for evaluating proteins in cerebrospinal fluid, and €35 for testing the apolipoprotein E e4 predisposition gene, also referred to as the ApoE e4 gene.
Modifiable risk factors and dementia prevention strategies
In discussing disease prevention, Tsolaki highlighted the substantial impact of addressing modifiable risk factors throughout a patient's life. Until recently, international clinical guidelines focused on 14 established risk factors: diabetes mellitus, midlife hypertension, obesity, physical inactivity, elevated LDL cholesterol levels, cigarette smoking, depression, low educational attainment, social isolation, traumatic brain injury, hearing impairment, vision loss, excessive alcohol consumption, and exposure to air pollution containing sulfur dioxide, carbon monoxide, ozone, and fine particulate matter.
Tsolaki emphasized that targeted intervention offers a 45 percent prevention potential. If these predisposing factors are managed early across populations, the total number of dementia cases projected worldwide by 2050 could be reduced by approximately half.
In July 2026, the World Health Organization expanded the recognized list of modifiable risk factors by adding five new categories. The first addition involves pharmaceutical management during menopause to cushion the abrupt drop in estrogen levels, a hormonal decline linked to the higher incidence of dementia observed among women.
The remaining four new risk factors identified by the World Health Organization include immediate emergency hospital treatment for ischemic strokes through thrombolytic therapy or mechanical thrombectomy to prevent vascular dementia, maintaining sleep duration between six and eight hours per 24-hour day, proper medical treatment for AIDS, and maintaining a balanced daily diet. Regarding AIDS, Tsolaki observed that when the infection is effectively treated, patients do not subsequently develop dementia associated with the condition.
Addressing inquiries regarding the preventive use of blood thinners, Tsolaki clarified that anticoagulant therapy is strictly reserved for individuals with diagnosed hypercoagulable blood disorders or those who have previously suffered a stroke or heart attack. She stressed that physicians do not recommend blood thinners for healthy individuals without underlying medical problems.
Monoclonal antibody therapies and healthcare coverage barriers
In therapeutic management, Tsolaki highlighted monoclonal antibody treatments, specifically lecanemab and donanemab, which have received regulatory approval from the United States Food and Drug Administration and the European Medicines Agency. These biologic drugs are designed for patients diagnosed with mild cognitive impairment or mild dementia, showing their greatest therapeutic effect when administered during the earliest stages of cognitive decline. Rather than reversing brain damage, the drugs work by slowing disease progression.
Despite regulatory clearance, patient access across Europe remains practically nonexistent. Tsolaki noted that no European nation has agreed to cover the financial cost of the treatment, which totals approximately €50,000 per patient over an 18-month therapeutic cycle. European governments backed away from public coverage because of high drug prices and the need to adjust upcoming annual health ministry budgets. Furthermore, approvals are complicated by potential adverse side effects, requiring strict clinical and laboratory eligibility criteria for every individual patient.
In contrast to Europe, one or both of these monoclonal antibody treatments have been approved and made available in several international jurisdictions, including the United States, Japan, Taiwan, the United Arab Emirates, China, Hong Kong, Israel, and South Korea.
Within Greece, treatment availability remains sharply divided by geography and financial capacity. In Athens, 30 patients have commenced monoclonal antibody therapy across public and private medical centers. However, no patients in Thessaloniki have received the treatment because local families lack the financial resources to pay the full cost out of pocket.
Both drugs are routinely administered via hospital intravenous infusions. Lecanemab recently gained approval abroad in a subcutaneous formulation that patients can administer at home, although this self-administered form has not yet received approval in Greece. Existing clinical trial data supports treatment for 18 months, with long-term extension studies tracking patient safety and efficacy up to four years provided no adverse side effects occur.
National strategic planning and patient support networks
In response to funding and care challenges, the Panhellenic Federation of Alzheimer's Disease and Related Disorders has called on the Greek state to provide full financial coverage for monoclonal antibody therapies to all patients who meet the clinical eligibility criteria. The federation's broader strategic priorities include drafting a comprehensive National Strategic Plan to build new dementia care infrastructure across the country, as well as expanding structured models of person-centered care following diagnosis.
Tsolaki underscored that patient support must continue regardless of whether pharmaceutical options are accessible. Specialized Day Centers operate across Greece to provide ongoing education, cognitive stimulation, and training for both dementia patients and their family caregivers. She affirmed that medical professionals and advocacy groups do not abandon patients simply because high drug costs limit access to the newest medications.
