Journal article
Blood-based Alzheimer's disease biomarkers in a behavioral neurology clinic: Real-world implementation, clinical utility, and diagnostic performance
Alzheimer's & dementia, Vol.21(11), pp.e70891-n/a
11/2025
DOI: 10.1002/alz.70891
PMID: 41231363
Abstract
Blood-based biomarkers (BBMs) for Alzheimer's disease (AD), including plasma phosphorylated tau (p-tau), are increasingly used in clinical practice, but "real-world" implementation patterns, context-of-use (COU), clinical utility, and diagnostic performance are incompletely understood.
A retrospective analysis of the first year of BBM use in a tertiary level cognitive neurology subspecialty clinic was conducted, including review of COU, impact on diagnostic certainty, prescription of AD-related medications, and additional AD-biomarker testing.
P-tau181 was ordered frequently to detect AD in a diverse cohort, across a wide spectrum of COU, including typical, early-onset, and atypical AD presentations; mixed etiology; AD co-pathology; and borderline symptoms. P-tau181 impacted diagnostic confidence, AD-related medication prescription, and follow-on testing. Renal impairment was a common confounder.
Implementation of BBMs was feasible and impactful in a memory clinic, especially in a diagnostically complex and diverse patient population, underscoring the need for additional data from real-world settings.
Blood-based biomarkers (BBMs) were quickly adopted and accelerated precision diagnosis in a large memory clinic. BBM use cases were diverse and included all stages/types of AD and non-AD syndromes. Plasma p-tau has the potential to impact diagnostic certainty and clinical decision making. Diagnostic performance of p-tau is reasonable, though renal function impacts overall accuracy.
Details
- Title: Subtitle
- Blood-based Alzheimer's disease biomarkers in a behavioral neurology clinic: Real-world implementation, clinical utility, and diagnostic performance
- Creators
- Igor Prufer Q C Araujo - University of California, San FranciscoTara Ellingson - University Memory and Aging CenterNicholas U Schwartz - University Memory and Aging CenterConnor D Dietz - University Memory and Aging CenterGautam Tammewar - University Memory and Aging CenterKaancan Deniz - University Memory and Aging CenterManizhe Eslami-Amirabadi - University Memory and Aging CenterAndrew G Breithaupt - Emory UniversityMarci Rosenberg - University Memory and Aging CenterNhat Minh Bui - University Memory and Aging CenterYasmeen Gonzalez - University Memory and Aging CenterRenaud La Joie - University Memory and Aging CenterPeter A Ljubenkov - University Memory and Aging CenterKatherine L Possin - University Memory and Aging CenterJulio C Rojas - University Memory and Aging CenterDavid N Soleimani-Meigooni - University Memory and Aging CenterYingbing Wang - University of California, San FranciscoAdam M Staffaroni - University Memory and Aging CenterMelanie L Stephens - University Memory and Aging CenterElena Tsoy - University Memory and Aging CenterCharles C Windon - University Memory and Aging CenterAdam L Boxer - University Memory and Aging CenterGil D Rabinovici - Emory UniversityBruce L Miller - University Memory and Aging CenterLawren VandeVrede - University Memory and Aging Center
- Resource Type
- Journal article
- Publication Details
- Alzheimer's & dementia, Vol.21(11), pp.e70891-n/a
- DOI
- 10.1002/alz.70891
- PMID
- 41231363
- NLM abbreviation
- Alzheimers Dement
- ISSN
- 1552-5260
- eISSN
- 1552-5279
- Grant note
- K23 AG093166 / NIA NIH HHS R01AG019724 / NIH HHS P30 AG062422 / NIA NIH HHS Shenandoah Foundation K23AG073514 / NIH HHS T32 AG023481 / NIA NIH HHS Alzheimer's Association P01AG038791 / NIH HHS U01 NS128913 / NINDS NIH HHS P30AG062422 / NIH HHS
- Language
- English
- Date published
- 11/2025
- Academic Unit
- Neurology
- Record Identifier
- 9985180927902771
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