Home › Research › Cognitive tests and assessment
Alzheimer’s disease diagnosis among dementia patients via blood biomarker measurement based on the AT(N) system
Tianyi Wang, Li Shang, Chenhui Mao, Longze Sha, Liling Dong, Caiyan Liu, Dan Lei, Jie Li et al.. Chinese Medical Journal, 2025-03-03
Topic: Amyloid, tau and blood-test diagnosis
A total of 156 patients were clinically diagnosed with dementia based on the 2011 NIA-AA criteria, regardless of specific disease etiology, and all exhibited significant brain atrophy on anatomical magnetic resonance imaging (MRI), indicating neuronal injury (N+). A significant difference in mini-mental state examination (MMSE) scores was noted between the A–N+ and A+T+N+ groups. Both the A+T–N+ and A+T+N+ groups showed a significantly decrease in the plasma Aβ42/40 ratio and an increase in plasma pTau181 and GFAP levels compared with the A–N+ group [Figure 1A]. No significant differences were found between the A+T–N+ and A+T+N+ groups in terms of plasma biomarker levels, although a trend toward progressively increasing plasma pTau181 levels was observed across the A–N+, A+T+N+, and A+T+N+ groups. Further comparisons between the A–N+ and A+N+ groups, as well as the PET– and PET+ groups, revealed similar trends, with reduced plasma Aβ42/40 ratios and elevated pTau181 and GFAP levels in the A+N+/PET+ group compared with those in the A–N+/PET– group [Figure 1B, C]. No significant differences in plasma NfL, Aβ42, and Aβ40 levels among groups were observed [Supplementary Figure 1B, C, https://links.lww.com/CM9/C317]. In summary, our findings demonstrate a strong association between plasma biomarker levels—particularly the Aβ42/40 ratio and pTau181 and GFAP levels—and brain Aβ pathology, as confirmed by CSF biomarker analysis and/or AV45 PET.Figure 1: Comparison of plasma AD biomarkers and their correlation with CSF AD biomarkers, along with machine learning model performance in dementia patients. Plasma Aβ42/40 ratio, pTau181, and GFAP exhibited significant correlations with multiple CSF biomarkers. Plasma Aβ42/40 ratios and pTau181 and GFAP levels were significantly correlated with various CSF biomarker levels, whereas plasma Aβ42, Aβ40, and NfL levels were not. Notably, plasma Aβ42/40 ratios showed a stronger correlation with CSF biomarker levels than either plasma Aβ42 levels or plasma Aβ40 levels alone did, suggesting that the Aβ42/40 ratio may reduce the influence from blood sample. Overall, plasma biomarker levels correlated more strongly with CSF Aβ biomarker levels than with CSF pTau levels or neuronal injury marker levels. Results showed no significant correlation, suggesting plasma biomarkers may not reliably indicate disease severity in this subgroup. The random forest model demonstrated the highest AUC (0.83) for predicting patient diagnoses. Additi
Key findings
- A total of 156 patients were clinically diagnosed with dementia based on the 2011 NIA-AA criteria, regardless of specific disease etiology, and all exhibited significant brain atrophy on anatomical magnetic resonance imaging (MRI), indicating neuronal injury (N+).
- A significant difference in mini-mental state examination (MMSE) scores was noted between the A–N+ and A+T+N+ groups.
- Both the A+T–N+ and A+T+N+ groups showed a significantly decrease in the plasma Aβ42/40 ratio and an increase in plasma pTau181 and GFAP levels compared with the A–N+ group [Figure 1A].
- No significant differences were found between the A+T–N+ and A+T+N+ groups in terms of plasma biomarker levels, although a trend toward progressively increasing plasma pTau181 levels was observed across the A–N+, A+T+N+, and A+T+N+ groups.
- Further comparisons between the A–N+ and A+N+ groups, as well as the PET– and PET+ groups, revealed similar trends, with reduced plasma Aβ42/40 ratios and elevated pTau181 and GFAP levels in the A+N+/PET+ group compared with those in the A–N+/PET– group [Figure 1B, C].
Why it matters
In 156 patients already diagnosed with dementia, certain plasma markers (the Aβ42/40 ratio, pTau181 and GFAP) tracked with the presence of brain amyloid, while plasma NfL, Aβ42 and Aβ40 did not differ between groups. This is a diagnostic association study, not a treatment trial, so it does not show that measuring these blood markers changes or prevents disease.
Study details
- Participants156
- Evidence strengthModerate
How this study scored 41/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Chinese Medical Journal) |
| Journal's citation record | 1 / 4 | Chinese Medical Journal: journal h-index 94 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 156 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Jing Gao: h-index 22 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Tsinghua University: institution h-index 1,218 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40025636) |
| Free to read | 2 / 2 | Free to read |
| Total | 41 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1097/cm9.0000000000003496
- PubMed: 40025636
- Original source →
- Free full text: Chinese Medical Journal →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Wang, T., Shang, L., Mao, C., Sha, L., Dong, L., Liu, C., et al. (2025). Alzheimer’s disease diagnosis among dementia patients via blood biomarker measurement based on the AT(N) system. Chinese Medical Journal. https://doi.org/10.1097/cm9.0000000000003496
Vancouver
Wang T, Shang L, Mao C, Sha L, Dong L, Liu C, et al. Alzheimer’s disease diagnosis among dementia patients via blood biomarker measurement based on the AT(N) system. Chinese Medical Journal. 2025. doi:10.1097/cm9.0000000000003496. PMID: 40025636.
BibTeX
@article{wang2025-40025636,
author = {Wang, Tianyi and Shang, Li and Mao, Chenhui and Sha, Longze and Dong, Liling and Liu, Caiyan and Lei, Dan and Li, Jie and others},
title = {{Alzheimer’s disease diagnosis among dementia patients via blood biomarker measurement based on the AT(N) system}},
journal = {Chinese Medical Journal},
year = {2025},
doi = {10.1097/cm9.0000000000003496},
pmid = {40025636},
url = {https://doi.org/10.1097/cm9.0000000000003496}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Related studies in Cognitive tests and assessment
Also tagged “biomarkers”
821 studies in the library carry the topic tag “biomarkers”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 821 tagged studies.