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Association of Plasma Phosphorylated Tau 217 With Clinical Deterioration Across Alzheimer Disease Stages
Selma-Gonzalez J, Rubio-Guerra S, García-Castro J, Vera-Campuzano E, Sala I, Sánchez-Saudinós MB, Zhu N, Arranz J et al.. Neurology, 2025-06-05
Topic: Amyloid, tau and blood-test diagnosis
Plain-language summary
Background and objectives Phosphorylated tau at threonine 217 (p-tau217) is a highly sensitive blood-based biomarker for Alzheimer disease (AD) pathology, showing high diagnostic accuracy. However, its prognostic value across different clinical stages of AD remains unclear. The aim of this study was to assess the prognostic utility of plasma p-tau217, measured using a commercially available immunoassay, regarding clinical and functional decline across the clinical stages of AD in a cohort with up to 10 years of follow-up. Methods We conducted a retrospective longitudinal cohort study using data from the Sant Pau Initiative on Neurodegeneration, a research project performed at the Sant Pau Memory Unit between 2011 and 2022. Participants were classified into clinical stages 1-6 based on AD pathology status in CSF, determined by the p-tau181/Aβ1-42 ratio. The primary outcomes were cognitive decline, measured by changes in the Mini-Mental State Examination (MMSE), and progression to dementia. Plasma p-tau217 and CSF p-tau181 levels were assessed, and statistical analysis was performed using linear mixed-effects models for longitudinal changes in MMSE scores and Cox proportional hazard regression was used to examine progression to dementia. Results A total of 731 participants (mean age 71.5 ± 10.1 years; 60% female) were included. Plasma p-tau217 levels showed a significant increase across advancing AD stages, with all between-group comparisons remaining significant after false discovery rate adjustment ( p p = 0.002) and CSF p-tau181 (β = 3.2, 95% CI 1.4-5.0, p = 0.001). Baseline plasma p-tau217 levels were associated with faster MMSE decline (β = -0.08, 95% CI -0.11 to -0.05, p p Discussion Plasma p-tau217 was significantly associated with cognitive and functional decline in AD. These findings support the potential use of plasma p-tau217 as a prognostic marker for monitoring AD progression in clinical practice. Future studies should validate these results across diverse cohorts and explore their utility in early-stage detection and monitoring.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Selma-Gonzalez, J., Rubio-Guerra, S., García-Castro, J., Vera-Campuzano, E., Sala, I., Sánchez-Saudinós, M. B., et al. (2025). Association of Plasma Phosphorylated Tau 217 With Clinical Deterioration Across Alzheimer Disease Stages. Neurology. https://doi.org/10.1212/wnl.0000000000213769
Vancouver
Selma-Gonzalez J, Rubio-Guerra S, García-Castro J, Vera-Campuzano E, Sala I, Sánchez-Saudinós MB, et al. Association of Plasma Phosphorylated Tau 217 With Clinical Deterioration Across Alzheimer Disease Stages. Neurology. 2025. doi:10.1212/wnl.0000000000213769. PMID: 40472304.
BibTeX
@article{selmagonzalez2025-40472304,
author = {Selma-Gonzalez, J. and Rubio-Guerra, S. and García-Castro, J. and Vera-Campuzano, E. and Sala, I. and Sánchez-Saudinós, M. B. and Zhu, N. and Arranz, J. and others},
title = {{Association of Plasma Phosphorylated Tau 217 With Clinical Deterioration Across Alzheimer Disease Stages}},
journal = {Neurology},
year = {2025},
doi = {10.1212/wnl.0000000000213769},
pmid = {40472304},
url = {https://doi.org/10.1212/wnl.0000000000213769}
}
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Key findings
- Results A total of 731 participants (mean age 71.5 ± 10.1 years; 60% female) were included.
- Plasma p-tau217 levels showed a significant increase across advancing AD stages, with all between-group comparisons remaining significant after false discovery rate adjustment ( p p = 0.002) and CSF p-tau181 (β = 3.2, 95% CI 1.4-5.0, p = 0.001).
- Baseline plasma p-tau217 levels were associated with faster MMSE decline (β = -0.08, 95% CI -0.11 to -0.05, p p Discussion Plasma p-tau217 was significantly associated with cognitive and functional decline in AD.
- These findings support the potential use of plasma p-tau217 as a prognostic marker for monitoring AD progression in clinical practice.
- Future studies should validate these results across diverse cohorts and explore their utility in early-stage detection and monitoring.
Why it matters
In 731 participants followed for up to 10 years, higher plasma p-tau217 levels were associated with faster cognitive decline and progression to dementia across Alzheimer's stages. This is a prognostic biomarker study and does not test any treatment, cure, or prevention for the disease.
New to this subject? Start with our plain-English guide: Blood tests & biomarkers →
Study details
- Study designcohort study
- Participants731
- Evidence strengthModerate
How this study scored 63/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for effect reported and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (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 | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 731 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) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 27 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 9.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 17.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 2 / 4 | Cited 27 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Ignacio Illán‐Gala: h-index 34 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Arizona: institution h-index 1,336 (OpenAlex) |
| Multicenter collaboration | 3 / 3 | OpenAlex lists 10 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40472304) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 63 / 100 | — |
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May need a subscription Unpaywall, Europe PMC and OpenAlex found no free copy of the full text (checked 10 Oct 2026), so the publisher may charge for it. The PubMed abstract is free.
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