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Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
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Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies
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Biomarkers.

Sylvia Villeneuve1

  • 1Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montréal, QC, Canada; McGill University, Montreal, QC, Canada; StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montreal, QC, Canada.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

Cognitively unimpaired individuals with both amyloid and tau pathology on PET scans invariably progress to mild cognitive impairment or dementia. Longer follow-up also reveals increased progression in those with only amyloid pathology.

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Area of Science:

  • Neuroscience
  • Biomarker Research
  • Alzheimer's Disease Diagnostics

Background:

  • Debate exists on classifying cognitively unimpaired individuals with Alzheimer's pathology as having Alzheimer's disease.
  • Previous studies indicated about half of amyloid-positive and tau-positive (A+T+) cognitively unimpaired individuals progressed to mild cognitive impairment (MCI) or dementia within 3.5 years.
  • Individuals with only amyloid pathology (A+T-) showed no increased risk of MCI or dementia compared to those with no pathology (A-T-).

Purpose of the Study:

  • To evaluate the prognostic value of amyloid and tau positron emission tomography (PET) biomarkers in identifying cognitively unimpaired individuals who will develop MCI within a 6-year timeframe.
  • To explore novel methods for detecting amyloid and tau PET positivity that may be more sensitive than conventional approaches.
  • To inform clinical trial enrollment by identifying individuals most likely to benefit from early interventions.

Main Methods:

  • Longitudinal follow-up of cognitively unimpaired participants in the PREVENT-AD study.
  • Assessment of cognitive status and progression to MCI or dementia.
  • Utilizing amyloid and tau PET biomarkers (A+T+, A+T-, A-T-) to categorize participants.
  • Analysis of updated cognitive status after an additional 2.4 years of follow-up.

Main Results:

  • 100% of A+T+ participants progressed to MCI or dementia with extended follow-up.
  • The progression rate in the A+T- group significantly increased from 9.09% to 42.42% with longer follow-up.
  • These findings provide strong evidence that combined amyloid and tau pathology predicts cognitive decline in unimpaired individuals.

Conclusions:

  • Cognitively unimpaired individuals with both amyloid plaques and tau aggregates detected by PET are certain to develop cognitive impairments if untreated.
  • The A+T- biomarker group shows a worse prognosis with longer follow-up, suggesting underlying tau pathology not always detectable by current PET thresholds.
  • Accurate biomarker assessment is crucial for early diagnosis, prognosis, and effective clinical trial design in Alzheimer's disease research.