# Plasma biomarkers of Alzheimer's disease improve prediction of cognitive decline in cognitively unimpaired elderly populations

Article · Cullen NC, Leuzy A, Janelidze S, Palmqvist S, Svenningsson AL, Stomrud E, Dage JL, Mattsson-Carlgren N, Hansson O

- Archive id: doi:10.1038/s41467-021-23746-0
- Published: 2021-06-11
- Venue: Nature communications
- DOI: https://doi.org/10.1038/s41467-021-23746-0
- PMID: 34117234
- PMCID: PMC8196018
- Citations: 240
- Source URL: https://doi.org/10.1038/s41467-021-23746-0
- PDF: https://europepmc.org/articles/PMC8196018/pdf
- Provenance: europepmc

## Abstract

Plasma biomarkers of amyloid, tau, and neurodegeneration (ATN) need to be characterized in cognitively unimpaired (CU) elderly individuals. We therefore tested if plasma measurements of amyloid-β (Aβ)42/40, phospho-tau217 (P-tau217), and neurofilament light (NfL) together predict clinical deterioration in 435 CU individuals followed for an average of 4.8 ± 1.7 years in the BioFINDER study. A combination of all three plasma biomarkers and basic demographics best predicted change in cognition (Pre-Alzheimer's Clinical Composite; R 2 = 0.14, 95% CI \[0.12-0.17\]; P \< 0.0001) and subsequent AD dementia (AUC = 0.82, 95% CI \[0.77-0.91\], P \< 0.0001). In a simulated clinical trial, a screening algorithm combining all three plasma biomarkers would reduce the required sample size by 70% (95% CI \[54-81\]; P \< 0.001) with cognition as trial endpoint, and by 63% (95% CI \[53-70\], P \< 0.001) with subsequent AD dementia as trial endpoint. Plasma ATN biomarkers show usefulness in cognitively unimpaired populations and could make large clinical trials more feasible and cost-effective.

_Abstract reproduced under CC-BY (article license as recorded by Europe PMC; abstract reproduced unmodified apart from markup removal)._

Topics: [Alzheimer's, Parkinson's & Neurodegeneration](https://space-kitty.com/topics/neurodegeneration)

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