Plasma biomarkers and incident clinical stage progression in the specialized memory clinic: a longitudinal study
Abstract
INTRODUCTIONThe utility of blood based Alzheimers disease (AD) biomarkers in predicting clinical trajectories remains uncertain.
METHODSWe assessed the diagnostic and prognostic performance of p-tau181, p-tau217, GFAP, and NfL in a large memory{square}clinic cohort (n=3,645) with comprehensive baseline clinical evaluation and annual follow{square}up for up to three decades.
RESULTSP-tau217, p-tau181 and GFAP were associated with amyloid-beta (A{beta}) pathology, while all biomarkers were elevated in AD and all-cause dementia. P-tau217 significantly outperformed others in detecting A{beta} pathology and clinical AD but performed similarly to NfL and GFAP for all-cause dementia. Prognostically, p{square}tau217 demonstrated the strongest association with cognitive decline, followed by GFAP and NfL, and best predicted progression status at 5{square} and 10{square} year intervals. All biomarkers provided added prognostic value beyond demographic and genetic covariates.
DISCUSSIONThese findings support plasma biomarkers for disease identification and risk stratification while underscoring the need for population{square}specific approaches.
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BibTeX
@misc{zeng2026plasma,
title = {{Plasma biomarkers and incident clinical stage progression in the specialized memory clinic: a longitudinal study}},
author = {Xuemei Zeng and Nicholas Heaton and Rebecca A. Deek and Michel N. Nafash and Marissa F. Farinas and Lamia T. Choity and Wasiu G. Balogun and Ruyu Shi and Margaret A. Bedison and Brian J. Lopresti and Cristy Matan and Neelesh K. Nadkarni and Alexandra Gogola and C. Elizabeth Shaaban and Howard J. Aizenstein and Dana L. Tudorascu and Tharick A. Pascoal and Victor L. Villemagne and Sarah B. Berman and Milos D. Ikonomovic and Robert A. Sweet and Julia K. Kofler and Beth E. Snitz and M. Ilyas Kamboh and Ann D. Cohen and Oscar L. Lopez and Thomas K. Karikari},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.19.26365317},
url = {https://www.medrxiv.org/content/10.64898/2026.10.19.26365317v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Plasma biomarkers and incident clinical stage progression in the specialized memory clinic: a longitudinal study
AU - Xuemei Zeng
AU - Nicholas Heaton
AU - Rebecca A. Deek
AU - Michel N. Nafash
AU - Marissa F. Farinas
AU - Lamia T. Choity
AU - Wasiu G. Balogun
AU - Ruyu Shi
AU - Margaret A. Bedison
AU - Brian J. Lopresti
AU - Cristy Matan
AU - Neelesh K. Nadkarni
AU - Alexandra Gogola
AU - C. Elizabeth Shaaban
AU - Howard J. Aizenstein
AU - Dana L. Tudorascu
AU - Tharick A. Pascoal
AU - Victor L. Villemagne
AU - Sarah B. Berman
AU - Milos D. Ikonomovic
AU - Robert A. Sweet
AU - Julia K. Kofler
AU - Beth E. Snitz
AU - M. Ilyas Kamboh
AU - Ann D. Cohen
AU - Oscar L. Lopez
AU - Thomas K. Karikari
PY - 2026
DA - 2026/10/19
PB - medRxiv
DO - 10.64898/2026.10.19.26365317
UR - https://www.medrxiv.org/content/10.64898/2026.10.19.26365317v1
AB - INTRODUCTIONThe utility of blood based Alzheimers disease (AD) biomarkers in predicting clinical trajectories remains uncertain. METHODSWe assessed the diagnostic and prognostic performance of p-tau181, p-tau217, GFAP, and NfL in a large memory{square}clinic cohort (n=3,645) with comprehensive baseline clinical evaluation and annual follow{square}up for up to three decades. RESULTSP-tau217, p-tau181 and GFAP were associated with amyloid-beta (A{beta}) pathology, while all biomarkers were elevated in AD and all-cause dementia. P-tau217 significantly outperformed others in detecting A{beta} pathology and clinical AD but performed similarly to NfL and GFAP for all-cause dementia. Prognostically, p{square}tau217 demonstrated the strongest association with cognitive decline, followed by GFAP and NfL, and best predicted progression status at 5{square} and 10{square} year intervals. All biomarkers provided added prognostic value beyond demographic and genetic covariates. DISCUSSIONThese findings support plasma biomarkers for disease identification and risk stratification while underscoring the need for population{square}specific approaches.
ER -