Clinical Impact and Prognostic Value of Alzheimer Disease Biomarkers in the Very Old
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND OBJECTIVES: Alzheimer disease (AD) is increasingly viewed as a clinical-biological continuum, but the utility of biomarkers in individuals aged ≥80 years, the so-called "very old," remains uncertain, because of concerns about its clinical usefulness. This study aimed to determine the clinical impact and prognostic value of AD biomarkers in very old individuals. METHODS: We performed a retrospective longitudinal cohort study within the Sant Pau Initiative on Neurodegeneration (SPIN, Barcelona, Spain), a memory clinic-based research cohort. Patients were referred from primary care physicians or community neurologists for evaluation within a public universal health care catchment area. We included SPIN participants evaluated between October 2013 and May 2024 who were aged ≥80 years and had mild cognitive impairment (MCI) at the baseline visit. Participants underwent standardized clinical and neuropsychological assessments and had CSF and plasma biomarker measurements available. AD biology was defined by the CSF phosphorylated tau at threonine 181/amyloid-β 42 ratio. Plasma phosphorylated tau at threonine 217 (p-Tau217) was evaluated for (1) diagnostic accuracy for AD biology and (2) prognostic associations with longitudinal cognitive change (Mini-Mental State Examination [MMSE]) and progression to dementia. Analyses used linear mixed-effects models for MMSE trajectories and Cox regression for dementia conversion. RESULTS: = 0.026). DISCUSSION: In very old individuals with MCI, AD biology (CSF) and plasma p-Tau217 identify individuals at higher risk of faster cognitive decline and progression to dementia. Limitations of this study include the single-center design and the modest sample size.
Source: Neurology
Authors: Chiara Ceriello, Olga H. Torres, Sara Rubio-Guerra, Jesús García-Castro, Judit Selma-Gonzalez, Isabel Sala, María Belén Sánchez-Saudinós, Laura Videla, Elena Vera-Campuzano, Javier Arranz, Íñigo Rodríguez-Baz, Lucía Maure-Blesa, Oriol Dols-Icardo, Sílvia Valldeneu, Isabel Barroeta, Miguel Santos-Santos, Maria Carmona-Iragui, Lídia Vaqué-Alcázar, Esther Alvarez-Sanchez, Oriol Lorente, Mireia Carreras, Alexandre Bejanin, Olivia Belbin, Alberto Lleó, Juan Fortea, Daniel Alcolea, Ignacio Illán-Gala
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Awards: Multimodal Imaging of Small Vessel Disease in Genetic AD, La estructura cerebral y el metabolismo en la enfermedad de Alzheimer preclínica. Interacciones entre nuevos y viejos biomarcadores, Estudios longitudinales de RM magnética estructural, de difusión y funcional en la enfermedad de Alzheimer preclínica esporádica y asociada al síndrome de Down, Assessing Peripheral Inflammation in DS at Different Stages of AD, Unveiling the impact of biological sex along sporadic and genetic FTLD, Estudio de biomarcadores bioquímicos y de imagen de angiopatía amiloide cerebral en el continuum de la enfermedad de Alzheimer esporádica y asociada al síndrome de Down, Multimodal Assessment of Brain Inflammatory Biomarkers in DS-associated AD
OpenAlex ID: W7165050006