Plasma p‐tau217, p‐tau181, and NfL as early indicators of dementia risk in a community cohort: The Shanghai Aging Study

Xiao, Zhenxu; Wu, Wanqing; Ma, Xiaoxi; Wu, Jie; Liang, Xiaoniu; Zhou, Xiaowen; Cao, Yang; Zhao, Qianhua; Ding, Ding

doi:10.1002/dad2.12514

Cited by 4 publications

(1 citation statement)

References 75 publications

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“…P-tau181 has been proven to accurately discriminate between Aβ and tau stages and correlate with their PET statuses [71]. It has been confirmed in multiple studies that other tau species, such as p-tau217 and particularly p-tau231, are as effective or even more effective for early AD detection than p-tau181 [72][73][74][75][76][77][78][79][80][81]. What makes p-tau variants useful biomarkers is their specificity for the so-called "biological AD", which means a positive status for both Aβ PET (A+) and tau PET (T+).…”

Section: P-tau Isoforms As Ad Biomarkers 71 P-tau Isoforms Are Effect...mentioning

confidence: 92%

Evaluating p-tau217 and p-tau231 as Biomarkers for Early Diagnosis and Differentiation of Alzheimer’s Disease: A Narrative Review

Jarek,

Mizerka,

Nuszkiewicz

et al. 2024

Biomedicines

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The escalating prevalence of Alzheimer’s disease (AD) highlights the urgent need to develop reliable biomarkers for early diagnosis and intervention. AD is characterized by the pathological accumulation of amyloid-beta plaques and tau neurofibrillary tangles. Phosphorylated tau (p-tau) proteins, particularly p-tau217 and p-tau231, have been identified as promising biomarker candidates to differentiate the disease progression from preclinical stages. This narrative review is devoted to a critical evaluation of the diagnostic accuracy, sensitivity, and specificity of p-tau217 and p-tau231 levels in the detection of AD, measured in plasma, serum, and cerebrospinal fluid, compared to established biomarkers. Additionally, the efficacy of these markers in distinguishing AD from other neurodegenerative disorders is examined. The significant advances offered by p-tau217 and p-tau231 in AD diagnostics are highlighted, demonstrating their unique utility in early detection and differential diagnosis. This comprehensive analysis not only confirms the excellent diagnostic capabilities of these markers, but also deepens the understanding of the molecular dynamics of AD, contributing to the broader scientific discourse on neurodegenerative diseases. This review is aimed to provide key information for researchers and clinicians across disciplines, filling interdisciplinary gaps and highlighting the role of p-tau proteins in revolutionizing AD research and clinical practice.

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Section: P-tau Isoforms As Ad Biomarkers 71 P-tau Isoforms Are Effect...mentioning

confidence: 92%

Evaluating p-tau217 and p-tau231 as Biomarkers for Early Diagnosis and Differentiation of Alzheimer’s Disease: A Narrative Review

Jarek,

Mizerka,

Nuszkiewicz

et al. 2024

Biomedicines

View full text Add to dashboard Cite

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The Bayesian approach for real‐world implementation of plasma p‐tau217 in tertiary care memory clinics in Thailand

Thanapornsangsuth,

Booncharoen,

Khieukhajee

et al. 2024

Alzheimer's & Dementia

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INTRODUCTIONPlasma phosphorylated tau (p‐tau)217 is a promising biomarker for Alzheimer's disease (AD) diagnosis, but its clinical implementation remains challenging. We propose a strategy based on Bayes’ theorem and test it in real‐life memory clinics.METHODSMemory clinic patients were evaluated by neurocognitive specialists for prespecified diagnosis and subsequently underwent blood collection for p‐tau217, cerebrospinal fluid, or amyloid positron emission tomography. Using cross‐validation, the Bayesian approach (pretest probability × individualized likelihood ratio) was compared to other models for AD diagnosis.RESULTSThe Bayesian strategy demonstrated an area under the receiver operating characteristic curve (AUC) of 0.98 (95% confidence interval [CI]: 0.96–1.0), significantly outperforming multivariable logistic regression (p‐tau217, age, apolipoprotein E; AUC 0.95, p = 0.024) and p‐tau217 alone (AUC = 0.94, p = 0.007). When applying the two‐threshold approach, the Bayesian strategy yielded an accuracy of 0.94 (95% CI: 0.88–1.0) without requiring confirmatory tests in 62.9% of the iterations.DISCUSSIONThe Bayesian strategy offers an effective and flexible approach to address the limitations of plasma p‐tau217 in clinical practice.Highlights Incorporating pretest probability into the interpretation of plasma phosphorylated tau (p‐tau)217 improves the diagnostic performance significantly. The strategy could obviate the need for confirmatory testing in most of the patients. Plasma p‐tau217 proves useful as a biomarker for Alzheimer's disease in low‐ and middle‐income country such as Thailand.

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Significance of plasma p‐tau217 in predicting long‐term dementia risk in older community residents: Insights from machine learning approaches

Xiao,

Zhou,

Zhao

et al. 2024

Alzheimer's & Dementia

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INTRODUCTIONWhether plasma biomarkers play roles in predicting incident dementia among the general population is worth exploring.METHODSA total of 1857 baseline dementia‐free older adults with follow‐ups up to 13.5 years were included from a community‐based cohort. The Recursive Feature Elimination (RFE) algorithm aided in feature selection from 90 candidate predictors to construct logistic regression, naive Bayes, bagged trees, and random forest models. Area under the curve (AUC) was used to assess the model performance for predicting incident dementia.RESULTSDuring the follow‐up of 12,716 person‐years, 207 participants developed dementia. Four predictive models, incorporated plasma p‐tau217, age, and scores of MMSE, STICK, and AVLT, exhibited AUCs ranging from 0.79 to 0.96 in testing datasets. These models maintained robustness across various subgroups and sensitivity analyses.DISCUSSIONPlasma p‐tau217 outperforms most traditional variables and may be used to preliminarily screen older individuals at high risk of dementia.Highlights Plasma p‐tau217 showed comparable importance with age and cognitive tests in predicting incident dementia among community older adults. Machine learning models combining plasma p‐tau217, age, and cognitive tests exhibited excellent performance in predicting incident dementia. The training models demonstrated robustness in subgroup and sensitivity analysis.

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Plasma p‐tau217, p‐tau181, and NfL as early indicators of dementia risk in a community cohort: The Shanghai Aging Study

Cited by 4 publications

References 75 publications

Evaluating p-tau217 and p-tau231 as Biomarkers for Early Diagnosis and Differentiation of Alzheimer’s Disease: A Narrative Review

Evaluating p-tau217 and p-tau231 as Biomarkers for Early Diagnosis and Differentiation of Alzheimer’s Disease: A Narrative Review

The Bayesian approach for real‐world implementation of plasma p‐tau217 in tertiary care memory clinics in Thailand

Significance of plasma p‐tau217 in predicting long‐term dementia risk in older community residents: Insights from machine learning approaches

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