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Alzheimer's Imaging Consortium.

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Summary
This summary is machine-generated.

Plasma p-tau217 and cognitive tests show promise for early Alzheimer's disease (AD) detection in unimpaired individuals. Combining these markers significantly improves the accuracy of identifying preclinical AD pathology.

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Area of Science:

  • Neuroscience
  • Biomarkers
  • Neuroimaging

Background:

  • Alzheimer's disease (AD) diagnosis relies on expensive amyloid (Aβ) and tau-PET imaging, limiting their use for screening unimpaired populations.
  • Research focuses on affordable methods for detecting pre-symptomatic AD pathology, including cognitive metrics and blood-based biomarkers like soluble phosphorylated tau (p-tau).
  • Head-to-head comparisons of these emerging markers and their additive value for early AD detection are scarce.

Purpose of the Study:

  • To investigate the utility of plasma p-tau217 and cognitive tasks in identifying clinically unimpaired (CU) individuals with PET-imaging evidence of AD pathology.
  • To compare the diagnostic accuracy of plasma p-tau217 and specific cognitive tests for detecting early AD.
  • To assess the additive value of combining plasma biomarkers and cognitive measures for early AD detection.

Main Methods:

  • Eighty CU older adults underwent plasma p-tau217 testing, Aβ-PET and tau-PET scans, and neuropsychological assessments including the Conceptual Matching Task (CMT) and Visual-Short Term Memory Binding Test (VSTMBT).
  • Participants were classified based on amyloid-PET (Aβ- or Aβ+) or tau-PET (Tau-CU or Tau+CU) status.
  • Receiver operating characteristic (ROC) curves were used to determine the accuracy of individual and combined markers in differentiating PET-positive from PET-negative individuals.

Main Results:

  • Plasma p-tau217 demonstrated the highest accuracy (AUC=0.91) in detecting incipient amyloidosis or tauopathy.
  • The VSTMBT was the most sensitive cognitive measure for detecting Aβ (AUC=0.722) and tau-PET positivity (AUC=0.743).
  • Combining plasma p-tau217 and cognitive markers achieved high accuracy (AUC=0.93 for Aβ, AUC=0.95 for tau) and improved sensitivity for detecting tau-PET positivity to 1.0.

Conclusions:

  • The combination of plasma biomarkers and cognitive measures shows significant promise for the early diagnosis of Alzheimer's disease.
  • This combined approach enhances the ability to identify preclinical AD pathology in clinically unimpaired individuals.
  • Further research validating these combined markers could lead to more accessible AD screening tools.