Biomarkers.

Area of Science:

• Neuroscience
• Biomarker Research
• Clinical Diagnostics

Background:

• Clinical-biological diagnosis of Alzheimer's disease (AD) is increasingly recognized.
• Biological profiles aid in disease monitoring and prognosis, but real-world data from memory clinics is limited.

Purpose of the Study:

• To evaluate the prognostic value of AD core biomarkers in a memory clinic setting.
• To compare the effectiveness of quantitative versus binary biomarker assessments for predicting clinical progression.

Main Methods:

• 211 subjects with cognitive concerns and 31 controls underwent longitudinal follow-up (mean 1.89 years).
• AD pathological evaluations included amyloid-PET/plasma p-tau217 and tau-PET.
• Biomarkers assessed as binary status and quantitative tau burden (MTL, NEO); clinical progression was the primary outcome.

Main Results:

• Age and sex were significant risk factors for clinical progression.
• Incorporating biomarkers individually significantly improved prognostic value (AUC 0.73-0.80), with quantitative tau burden in NEO showing the best performance.
• Combining amyloid and tau biomarkers further enhanced prognosis (AUC 0.77-0.82), with binary amyloid + quantitative tau in NEO being optimal.

Conclusions:

• AD core biomarkers show promise for improving clinical prognosis in memory clinic populations.
• Quantitative tau burden assessment is superior to binary assessment for predicting prognosis, especially within the AD continuum.