Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring最新文献

{"title":"Association between BrainAGE and Alzheimer's disease biomarkers: Comment.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1002/dad2.70505","DOIUrl":"10.1002/dad2.70505","url":null,"abstract":"","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 4","pages":"e70505"},"PeriodicalIF":4.4,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amyloid, p-tau, neurofilament light, and α-synuclein cerebrospinal fluid biomarkers across Alzheimer's disease, dementia with Lewy bodies, and Parkinson's disease.","authors":"Marianna Rizzo, Charlotte E Teunissen, Henrik Zetterberg, Kaj Blennow, Gwendlyn Kollmorgen, Rejko Krüger, Sara B G Fernandes, Dag Aarsland, Olga Borejko, Michele Hu, Davit Chokoshvili, Jort E G B Vijverberg, Afina W Lemstra, Betty M Tijms, Gabor C Petzold, Kathrin Brockmann, Thomas Gasser, Giovanni B Frisoni, Jakub Hort, Zuzana Nedelska, Ann-Cecilie Hopøy, Tormod Fladby, Frank Jessen, Emrah Düzel, Annika Spottke, Günter U Höglinger, Sophie Mutel, Claire Chevalier, Rajaraman Krishnan, Pieter Jelle Visser, Stephanie J B Vos","doi":"10.1002/dad2.70498","DOIUrl":"10.1002/dad2.70498","url":null,"abstract":"<p><strong>Introduction: </strong>Mounting evidence suggests overlapping pathology across Alzheimer's disease (AD), dementia with Lewy bodies (DLB), and Parkinson's disease (PD), yet its extent and clinical implications remain unclear.</p><p><strong>Methods: </strong>Cerebrospinal fluid (CSF) amyloid beta (Aβ)42/40, phosphorylated tau 181 (p-tau181), neurofilament light chain (NfL), and total α-synuclein were centrally measured using fully-automated Elecsys immunoassays in 347 participants (European Platform for Neurodegenerative Diseases [EPND] cohort) and compared between groups. Associations of amyloid and tau positivity with cognitive and motor function were evaluated.</p><p><strong>Results: </strong>Compared to controls, amyloid and tau levels were abnormal in DLB, but not in PD. Amyloid and tau positivity in DLB were associated with worse global cognitive outcomes, but not with motor performance. NfL levels were elevated across diseases, and total α-synuclein levels were associated with tau positivity.</p><p><strong>Discussion: </strong>AD pathology is observed in DLB, and related to worse cognition, but it is less observed in PD. CSF NfL captures non-disease-specific processes, whereas CSF total α-synuclein likely reflects CSF tau positivity. Results can help patient management in clinical practice and trials.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 4","pages":"e70498"},"PeriodicalIF":4.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral microbleed assessment on MRI in a memory clinic: Reliability, prevalence, and implications for anti-amyloid therapy.","authors":"Ernest Privšek, Anna Marseglia, Igor Košutić, Anna Rosenberg, Tobias Granberg, Milica G Kramberger, Miia Kivipelto, Eric Westman","doi":"10.1002/dad2.70472","DOIUrl":"https://doi.org/10.1002/dad2.70472","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral microbleeds (CMBs) represent an important magnetic resonance imaging (MRI) marker of cerebral small vessel pathology in memory-clinic populations, where vascular and neurodegenerative pathologies frequently overlap.</p><p><strong>Methods: </strong>This cross-sectional study included 747 patients from a Swedish memory clinic who underwent 3T MRI with susceptibility-weighted imaging. Two readers assessed CMBs using standardized criteria. Inter- and intra-observer agreement were evaluated before and after protocol refinement. CMB prevalence and burden were analyzed across diagnostic groups and by cerebrospinal fluid amyloid status.</p><p><strong>Results: </strong>CMBs were present in 28.6% of patients and frequently observed in subjects with mild cognitive impairment or dementia. Inter-observer agreement improved from κ = 0.71 to κ = 0.82 after protocol refinement. Among amyloid-positive patients with cognitive impairment, 11.2% exceeded proposed CMB thresholds for anti-amyloid therapy eligibility.</p><p><strong>Discussion: </strong>Standardized CMB assessment improves reliability in memory-clinic populations. Given its growing impact on treatment eligibility and safety, consistent evaluation is essential for patient management.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 4","pages":"e70472"},"PeriodicalIF":4.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline CSF tau and short-term clinical change during lecanemab therapy: A prospective real-world cohort study in Japan.","authors":"Ryuichi Takahashi, Tetsuo Kashibayashi, Jun Fujita, Kohsuke Yoshida, Akira Hashiramoto, Hisatomo Kowa, Eiji Mizuta","doi":"10.1002/dad2.70487","DOIUrl":"https://doi.org/10.1002/dad2.70487","url":null,"abstract":"<p><strong>Introduction: </strong>Real-world prognostic evidence for cerebrospinal fluid (CSF) biomarkers during lecanemab therapy remains limited. We examined whether baseline CSF phosphorylated tau 181 (pTau181), total tau, and amyloid beta (Aβ) 42/Aβ40 were associated with 6-month clinical change.</p><p><strong>Methods: </strong>This prospective single-center cohort included 50 patients with early Alzheimer's disease spectrum treated with lecanemab. CSF biomarkers were measured using the Lumipulse G system. The primary outcome was 6-month change in Clinical Dementia Rating Sum of Boxes (CDR-SB). Models were adjusted for age, sex, and baseline Mini-Mental State Examination; sensitivity analyses included APOE ε4 status.</p><p><strong>Results: </strong>CDR-SB worsening occurred in 19 participants (38.0%). Higher pTau181 (β per SD = 0.408; 95% CI: 0.106 to 0.709; <i>p</i> = 0.0091) and total tau (<i>β</i> = 0.341; 95% CI: 0.032 to 0.651; <i>p</i> = 0.0314) were associated with worsening. Aβ42/Aβ40 was not.</p><p><strong>Discussion: </strong>Baseline CSF pTau181 and total tau were associated with 6-month clinical trajectories, supporting cautious cohort-level risk stratification.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 4","pages":"e70487"},"PeriodicalIF":4.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of plasma neurofilament and glial fibrillary acidic protein to predict or detect amyloid related imaging abnormalities.","authors":"Nicholas U Schwartz, Tara Ellingson, Hong Nguyen, Zoe Lin, Nicholas J Ashton, Jeffrey L Dage, Kaancan Deniz, Connor D Dietz, Peter A Ljubenkov, Bruce L Miller, Kambiz Nael, Katherine Possin, Julio C Rojas, Howie J Rosen, Rowan Saloner, David N Soleimani-Meigooni, Adam M Staffaroni, Melanie L Stephens, Gautam Tammewar, Yingbing Wang, Renaud La Joie, Gil D Rabinovici, Adam L Boxer, Lawren VandeVrede","doi":"10.1002/dad2.70446","DOIUrl":"https://doi.org/10.1002/dad2.70446","url":null,"abstract":"<p><strong>Introduction: </strong>Amyloid-targeting therapies (ATT) require frequent magnetic resonance imaging monitoring to detect vasogenic edema and hemorrhage, i.e., amyloid-related imaging abnormalities (ARIA). Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are potential blood-based biomarkers (BBM) of ARIA.</p><p><strong>Methods: </strong>Plasma NfL and GFAP were longitudinally collected in an ATT clinic and natural log transformed. Baseline, pre-ARIA, and trajectories were compared between patients with (<i>N =</i> 15) and without (<i>N =</i> 45) ARIA.</p><p><strong>Results: </strong>Baseline NfL and GFAP did not differ between patients with or without ARIA (ln[NfL] ECLIA 1.24 ± 0.38 pg/mL vs 1.25 ± 0.40 pg/mL, <i>p =</i> 0.77; ln[NfL] Simoa 2.87 ± 0.47 pg/mL vs 2.98 ± 0.40 pg/mL, <i>p =</i> 0.30, ln[GFAP] ECLIA 4.95 ± 0.36 pg/mL vs 4.88 ± 0.47 pg/mL, <i>p =</i> 0.69). No significant changes were seen at the timepoint preceding ARIA, and ARIA incidence made no detectable impact on biomarker trajectories.</p><p><strong>Discussion: </strong>Biobanking in treatment clinics can evaluate clinical utility of BBMs as monitoring tools. These findings do not support a strong association between NfL or GFAP and ARIA in the ATT clinic.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 4","pages":"e70446"},"PeriodicalIF":4.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Locally deployed large language model for real-world lecanemab eligibility pre-screening.","authors":"Carolin Miklitz, Maya Shrestha, Wegner Philipp, Nils Henk, Alois Martin Sprinkart, Wolfgang Block, Julian Alexander Luetkens, Alexander Radbruch, Nils Christian Lehnen, Sebastian Nowak","doi":"10.1002/dad2.70495","DOIUrl":"10.1002/dad2.70495","url":null,"abstract":"<p><strong>Introduction: </strong>The introduction of disease-modifying Alzheimer's therapies requires complex, labor-intensive patient screening. Cloud-based large language models (LLMs) could support this task but are often unsuitable for routine care due to data protection constraints.</p><p><strong>Methods: </strong>We evaluated an on-premises, open-weights LLM (gpt-oss-120b) for automated extraction of therapy-relevant variables for lecanemab eligibility from German memory clinic reports. In a two-stage design, LLM-based extraction prompts, a deterministic rule-based extractor, and a shared downstream rule-based classifier were optimized on a development set (<i>n</i> = 97) and evaluated on an independent hold-out set (<i>n</i> = 99), with expert consensus as ground truth.</p><p><strong>Results: </strong>The LLM-based pipeline achieved 94% accuracy and a Cohen's kappa of 0.90 on the hold-out set, significantly surpassing the rule-based comparator (80% accuracy) and demonstrating performance comparable to human experts.</p><p><strong>Discussion: </strong>A locally deployed, on-premises LLM may assist eligibility screening as a triage support tool, potentially facilitating access to novel therapies without compromising patient data privacy.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70495"},"PeriodicalIF":4.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening GGC repeat expansion in the <i>NOTCH2NLC</i> in early-onset dementia: The Longitudinal Study of Early Onset Dementia and Family Members (LEAF) Study.","authors":"Seung-Yeon Lee, Takeshi Mizuguchi, Hee Jin Kim, Young-Eun Kim, Cho Hanna, Won-Joo Kim, Gha-Hyun Lee, Ahro Kim, Ji-Yun Park, Eun Joo Chung, Hyemin Jang, Na-Yeon Jung, Sun Min Lee, Sang Won Seo, Seong-Ho Koh, Henrik Zetterberg, Liana G Apostolova, Naomichi Matsumoto, So Young Moon, Eun-Joo Kim","doi":"10.1002/dad2.70482","DOIUrl":"10.1002/dad2.70482","url":null,"abstract":"<p><strong>Background: </strong>Neuronal intranuclear inclusion disease (NIID) is neurodegenerative disorder caused by GGC repeat expansion in <i>NOTCH2NLC</i>. Given its frequency in young East Asian adults and overlap with cognitive impairment in young adults, a key feature of early-onset dementia (EOD), we screened <i>NOTCH2NLC</i> GGC repeat expansions in Korean patients with EOD.</p><p><strong>Methods: </strong>We screened <i>NOTCH2NLC</i> GGC repeat expansions in 410 Korean patients with EOD using repeat-primed and amplicon length polymerase chain reaction. Plasma biomarkers in adult-onset leukodystrophy were additionally measured using Simoa-based ultrasensitive immunoassays.</p><p><strong>Results: </strong>GGC repeat expansions were not identified in early-onset Alzheimer's disease (AD) or frontotemporal dementia (FTD), while four of eleven patients with adult-onset leukodystrophy (36.3%) had abnormal expansions. Plasma neurofilament light chain (NfL) level was lower in NIID than in colony-stimulating factor 1 receptor-related disorder.</p><p><strong>Discussion: </strong>These findings support recent arguments that the concept of <i>NOTCH2NLC</i>-related GGC repeat expansion disorder (NRED) should be reconsidered. Plasma NfL may be useful in differential diagnosis of adult-onset leukodystrophy.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70482"},"PeriodicalIF":4.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"APOE and amyloid-tau pathology in cognitively unimpaired older adults.","authors":"Carlos Albarrán Morillo, Lukai Zheng, Elham Ghanbarian, Babak Khorsand, Crystal M Glover, Joshua D Grill, S Ahmad Sajjadi, Ali Ezzati","doi":"10.1002/dad2.70496","DOIUrl":"10.1002/dad2.70496","url":null,"abstract":"<p><strong>Introduction: </strong>Apolipoprotein E (APOE) genotype shows well-established dose-dependent associations with higher amyloid in cognitively unimpaired (CU) adults. In contrast, associations with tau burden and cognition are less well characterized.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of CU participants from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4), Alzheimer's Disease Neuroimaging Initiative (ADNI), Wisconsin Registry for Alzheimer's Prevention (WRAP), and National Alzheimer's Coordinating Center (NACC) within the harmonized multi-cohort Alzheimer's Disease Sequencing Project Phenotype Harmonization Consortium (ADSP-PHC) data. A total of 4380 CU participants were included with APOE genotype, amyloid PET, and cognitive data (memory, language, executive, and visuospatial function), including a subset of 758 with tau PET imaging.</p><p><strong>Results: </strong>Compared with ε33, ε24 (β = 18.340), ε34 (β = 23.850), and ε44 (β = 44.820) showed higher amyloid burden (all <i>p</i> < .001). Similarly, ε24 (OR = 4.180), ε34 (OR = 4.540), and ε44 (OR = 14.150) had higher odds of amyloid positivity (all <i>p</i> < .001). After adjustment for amyloid burden, ε4 carriers had higher tau burden in the entorhinal cortex (<i>β</i> = 0.026; false discovery rate [FDR] -adjusted <i>p</i> = 0.041) and amygdala (<i>β</i> = 0.040; FDR-adjusted <i>p</i> = 0.003). Higher tau burden was associated with lower memory (<i>β</i> = -0.439; FDR-adjusted <i>p</i> = 0.012) and language performance (<i>β</i> = -0.610; FDR-adjusted <i>p</i> = 0.020).</p><p><strong>Discussion: </strong>APOE ε4 showed a strong dose-dependent association with amyloid, with the highest levels observed among ε4 homozygotes. Associations between APOE and global tau were more modest and appeared to be driven mainly by ε4 homozygotes, while regional analyses showed localized APOE ε4-related associations in medial temporal regions. Independently, higher tau was associated with lower memory and language performance.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70496"},"PeriodicalIF":4.4,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severity and progression of visual impairment and risk of dementia.","authors":"Allen T C Lee, Owen N W Leung, Zhaohua Huo, Jessie O T Kwok, Kelvin K L Chong, Wai C Chan, Ada W T Fung, Suk L Ma, Ruby S Y Lee, Marcus Richards, Sheung-Tak Cheng, Linda C W Lam","doi":"10.1002/dad2.70499","DOIUrl":"10.1002/dad2.70499","url":null,"abstract":"<p><strong>Introduction: </strong>Visual impairment is associated with dementia risk, but the role of severity and longitudinal change remains unclear. We examined whether visual impairment severity and its progression were associated with incident dementia.</p><p><strong>Methods: </strong>This territory-wide cohort study followed 15,576 community-dwelling older adults without dementia at baseline for 16 years. Incident dementia was ascertained using International Classification of Diseases, Tenth Revision diagnoses or Clinical Dementia Rating scores of 1 to 3. Visual acuity was measured using the Snellen chart. Cox models estimated hazard ratios, excluding dementia cases occurring within the first 6 years to minimize reverse causation and adjusting for demographic, comorbidity, and lifestyle factors.</p><p><strong>Results: </strong>Moderate to severe visual impairment and faster visual acuity decline were associated with increased dementia risk. Severe visual impairment was associated with dementia onset 2.1 years earlier than normal vision.</p><p><strong>Discussion: </strong>These findings strengthen the evidence for visual impairment as a dementia risk factor, supporting incorporation of visual assessment into dementia risk stratification.</p><p><strong>Trial registration: </strong>The Chinese Clinical Trial Registry: ChiCTR1900023536.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70499"},"PeriodicalIF":4.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of LUMIPULSE plasma p-tau217 to identify amyloid positivity among candidates for amyloid-targeting treatments in a real-world cohort.","authors":"Ryosuke Shimasaki, Masanori Kurihara, Kenichiro Sato, Taro Bannai, Keiko Hatano, Kenji Ishii, Ryoko Ihara, Sumito Ogawa, Atsushi Iwata","doi":"10.1002/dad2.70497","DOIUrl":"10.1002/dad2.70497","url":null,"abstract":"<p><strong>Introduction: </strong>Increasing clinical use of amyloid-targeting treatments (ATTs) requires accessible biomarkers for Alzheimer's disease (AD). Although the utility of plasma phosphorylated tau 217 (p-tau217) is well established in research cohorts and its use for identifying amyloid positivity among ATT candidates is expanding into clinical practice, real-world evidence of its performance is lacking.</p><p><strong>Methods: </strong>We evaluated the utility of LUMIPULSE plasma p-tau217 in a real-world cohort of 99 patients screened for ATT eligibility.</p><p><strong>Results: </strong>Amyloid positivity was confirmed in 82 (82.8%) patients. Plasma p-tau217 predicted amyloid status, with an area under the curve of 0.93. With a cutpoint (0.1795 pg/mL) based on the Youden index, this approach achieved 95.1% sensitivity, 94.1% specificity, 98.7% positive predictive value, and 80.0% negative predictive value (NPV). Higher external thresholds led to a lower NPV, demonstrating that cut points must be optimized for clinical stages.</p><p><strong>Discussion: </strong>These findings provide real-world evidence supporting the clinical utility of p-tau217 for ATT candidates.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70497"},"PeriodicalIF":4.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}