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64/100

✓ Peer-reviewed alzhub usefulness score 64 out of 100. Biomarkers

Topic: Brain proteins, microglia and lab models

Plain-language summary

Results The mean (SD) age was 73.9 (7.35) years among the 237 ADNI participants and 70.2 (9.7) years among the 130 Avid-A05 participants. Across both samples, we found that higher amyloid PET-mediated ApoE4-related tau PET increased globally (ADNI b, 0.15; 95% CI, 0.05-0.28; P = .001 and Avid-A05 b, 0.33; 95% CI, 0.14-0.54; P Conclusions and relevance The findings in this study indicate that amyloid-related tau accumulation was accelerated in ApoE4 carriers at lower amyloid levels, suggesting that ApoE4 may facilitate earlier amyloid-driven tau spreading across connected brain regions.

What this study adds

Evidence grade: Moderate

This is a follow-up (cohort) study of 237 participants. This cohort study found that in ApoE4 carriers, tau accumulation related to amyloid was accelerated at lower amyloid levels, suggesting ApoE4 may facilitate earlier spreading of tau across connected brain regions. Reported effect size: 45.1%; 34.6%.

Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Steward, A., Biel, D., Dewenter, A., Roemer, S., Wagner, F., Dehsarvi, A., et al. (2023). ApoE4 and Connectivity-Mediated Spreading of Tau Pathology at Lower Amyloid Levels. JAMA neurology. https://doi.org/10.1001/jamaneurol.2023.4038

Vancouver

Steward A, Biel D, Dewenter A, Roemer S, Wagner F, Dehsarvi A, et al. ApoE4 and Connectivity-Mediated Spreading of Tau Pathology at Lower Amyloid Levels. JAMA neurology. 2023. doi:10.1001/jamaneurol.2023.4038. PMID: 37930695.

BibTeX

@article{steward2023-37930695,
  author  = {Steward, A. and Biel, D. and Dewenter, A. and Roemer, S. and Wagner, F. and Dehsarvi, A. and Rathore, S. and Otero Svaldi, D. and others},
  title   = {{ApoE4 and Connectivity-Mediated Spreading of Tau Pathology at Lower Amyloid Levels}},
  journal = {JAMA neurology},
  year    = {2023},
  doi     = {10.1001/jamaneurol.2023.4038},
  pmid    = {37930695},
  url     = {https://doi.org/10.1001/jamaneurol.2023.4038}
}

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.

How to read this study

Design: this is a follow-up (cohort) study. People are observed over time and not assigned to anything, so an association can reflect other differences between groups. Look at how long follow-up lasted, how many dropped out, and whether the authors adjusted for age, education and other health conditions.
Size: the record lists 237 participants. Ask whether that is enough for the question, and who they were.
Effect: the record reports “45.1%; 34.6%”. A statistically significant result can still be small in daily life.

What the evidence grade means here

This page is graded moderate. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. Moderate means the abstract mentions a cohort, case-control or longitudinal design. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

New to reading papers? Six questions to ask of any Alzheimer’s study · how we score.

Key findings

Results The mean (SD) age was 73.9 (7.35) years among the 237 ADNI participants and 70.2 (9.7) years among the 130 Avid-A05 participants.
Across both samples, we found that higher amyloid PET-mediated ApoE4-related tau PET increased globally (ADNI b, 0.15; 95% CI, 0.05-0.28; P = .001 and Avid-A05 b, 0.33; 95% CI, 0.14-0.54; P < .001) and in earlier Braak regions.

Why it matters

This cohort study found that in ApoE4 carriers, tau accumulation related to amyloid was accelerated at lower amyloid levels, suggesting ApoE4 may facilitate earlier spreading of tau across connected brain regions. It does not report any treatment, cure, or prevention of Alzheimer's disease.

New to this subject? Start with our plain-English guide: Blood tests & biomarkers →

Study details

Study designcohort study
Participants237
Effect size45.1%; 34.6%
Evidence strengthModerate

How this study scored 64/100

Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (JAMA neurology)
Journal's citation record	2 / 4	JAMA Neurology: journal h-index 235 (OpenAlex, 2026-10-29)
Study design	7 / 12	A cohort study following people over time
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	3 / 5	2023 — within 6 year(s) of the newest study here
Sample size	2 / 4	237 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	4 / 7	Cited 67 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	13.4 citations a year over 5 year(s) since 2023
Impact for its field and year	4 / 6	Cited 9.8× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	2 / 6	Cited by 7 other studies in this library
Still being cited	3 / 4	Cited 66 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Nicolai Franzmeier: h-index 49 (OpenAlex, whole career)
Institution's track record	1 / 3	Ludwig-Maximilians-Universität München: institution h-index 1,224 (OpenAlex)
Multicenter collaboration	2 / 3	OpenAlex lists 6 institution(s) in 3 countries
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 37930695)
Free to read	0 / 2	Behind a paywall — scores zero
Total	64 / 100	—

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Read the original

Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).

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