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4w ago

Blood p‑tau217 Test Predicts Elevated 5‑ and 10‑Year Alzheimer’s Risk

A large pooled JAMA study shows very high plasma p‑tau217 levels identify people at much higher risk of future cognitive impairment and could reshape trial recruitment and early care if treatments prove effective.

FILE - A human brain affected by Alzheimer's disease is displayed at the Museum of Neuroanatomy at the University at Buffalo in Buffalo, N.Y., on Oct. 7, 2003. (AP Photo/David Duprey, File)
Blood tests for Alzheimer's are promising, but doctors need to learn best practices for use, experts say.
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Overview

  • Researchers published in JAMA on Wednesday that a pooled analysis of six cohorts totalling 2,684 cognitively unimpaired older adults found people with very high plasma p‑tau217 faced about a 38% risk of cognitive impairment at five years and about a 78% risk at 10 years.
  • The test added prognostic information beyond amyloid PET scans and APOE4 genetic status, meaning p‑tau217 appears to capture disease biology not fully shown by amyloid imaging.
  • The study followed participants for a median of 5.4 years and recorded 478 progressions to cognitive impairment, but far fewer people had decade‑long follow up so the 10‑year estimates are less certain.
  • Investigators and clinical guidelines caution against routine screening of symptom‑free people today and recommend using the test now mainly to find high‑risk volunteers for prevention trials.
  • Before clinical use, researchers say p‑tau217 needs validation in more diverse, real‑world populations, clear assay thresholds, longer follow up, and evidence from trials that early treatment guided by the test improves patient outcomes.