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Blood-based Alzheimer's disease biomarkers in a behavioral neurology clinic: Real-world implementation, clinical utility, and diagnostic performance
Journal article   Open access   Peer reviewed

Blood-based Alzheimer's disease biomarkers in a behavioral neurology clinic: Real-world implementation, clinical utility, and diagnostic performance

Igor Prufer Q C Araujo, Tara Ellingson, Nicholas U Schwartz, Connor D Dietz, Gautam Tammewar, Kaancan Deniz, Manizhe Eslami-Amirabadi, Andrew G Breithaupt, Marci Rosenberg, Nhat Minh Bui, …
Alzheimer's & dementia, Vol.21(11), pp.e70891-n/a
11/2025
DOI: 10.1002/alz.70891
PMID: 41231363
url
https://doi.org/10.1002/alz.70891View
Published (Version of record) Open Access

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.
Aged Aged, 80 and over Alzheimer Disease - blood Alzheimer Disease - diagnosis Biomarkers - blood Female Humans Male Middle Aged Retrospective Studies tau Proteins - blood

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