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Highly accurate blood test for Alzheimer's disease is similar or superior to clinical cerebrospinal fluid tests
Barthélemy NR, Salvadó G, Schindler SE, He Y, Janelidze S, Collij LE, Saef B, Henson RL et al.. Nature medicine, 2024-02-21
Topic: Amyloid, tau and blood-test diagnosis
With the emergence of Alzheimer's disease (AD) disease-modifying therapies, identifying patients who could benefit from these treatments becomes critical. In this study, we evaluated whether a precise blood test could perform as well as established cerebrospinal fluid (CSF) tests in detecting amyloid-β (Aβ) plaques and tau tangles. Plasma %p-tau217 (ratio of phosporylated-tau217 to non-phosphorylated tau) was analyzed by mass spectrometry in the Swedish BioFINDER-2 cohort (n = 1,422) and the US Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC) cohort (n = 337). Matched CSF samples were analyzed with clinically used and FDA-approved automated immunoassays for Aβ42/40 and p-tau181/Aβ42. The primary and secondary outcomes were detection of brain Aβ or tau pathology, respectively, using positron emission tomography (PET) imaging as the reference standard. Main analyses were focused on individuals with cognitive impairment (mild cognitive impairment and mild dementia), which is the target population for available disease-modifying treatments. Plasma %p-tau217 was clinically equivalent to FDA-approved CSF tests in classifying Aβ PET status, with an area under the curve (AUC) for both between 0.95 and 0.97. Plasma %p-tau217 was generally superior to CSF tests in classification of tau-PET with AUCs of 0.95-0.98. In cognitively impaired subcohorts (BioFINDER-2: n = 720; Knight ADRC: n = 50), plasma %p-tau217 had an accuracy, a positive predictive value and a negative predictive value of 89-90% for Aβ PET and 87-88% for tau PET status, which was clinically equivalent to CSF tests, further improving to 95% using a two-cutoffs approach. Blood plasma %p-tau217 demonstrated performance that was clinically equivalent or superior to clinically used FDA-approved CSF tests in the detection of AD pathology. Use of high-performance blood tests in clinical practice can improve access to accurate AD diagnosis and AD-specific treatments.
Key findings
- Blood plasma %p-tau217 demonstrated performance that was clinically equivalent or superior to clinically used FDA-approved CSF tests in the detection of AD pathology.
Why it matters
A blood test measuring plasma %p-tau217 performed as well as or better than FDA-approved cerebrospinal fluid tests at detecting amyloid plaques and tau tangles. This concerns diagnosis in people who might qualify for existing disease-modifying therapies, not a new treatment, cure or prevention.
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Study details
- Participants1,422
- Evidence strengthModerate
How this study scored 74/100
Published in a top-tier journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (Nature medicine) |
| Journal's citation record | 4 / 4 | Nature Medicine: journal h-index 763 (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 | 2024 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,422 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 | 6 / 7 | Cited 442 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 110.5 citations a year over 4 year(s) since 2024 |
| Impact for its field and year | 6 / 6 | Cited 120.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 55 other studies in this library |
| Still being cited | 4 / 4 | Cited 442 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Oskar Hansson: h-index 148 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,962 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 38382645) |
| Free to read | 2 / 2 | Free to read |
| Total | 74 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).
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
Barthélemy, N. R., Salvadó, G., Schindler, S. E., He, Y., Janelidze, S., Collij, L. E., et al. (2024). Highly accurate blood test for Alzheimer's disease is similar or superior to clinical cerebrospinal fluid tests. Nature medicine. https://doi.org/10.1038/s41591-024-02869-z
Vancouver
Barthélemy NR, Salvadó G, Schindler SE, He Y, Janelidze S, Collij LE, et al. Highly accurate blood test for Alzheimer's disease is similar or superior to clinical cerebrospinal fluid tests. Nature medicine. 2024. doi:10.1038/s41591-024-02869-z. PMID: 38382645.
BibTeX
@article{barthelemy2024-38382645,
author = {Barthélemy, N. R. and Salvadó, G. and Schindler, S. E. and He, Y. and Janelidze, S. and Collij, L. E. and Saef, B. and Henson, R. L. and others},
title = {{Highly accurate blood test for Alzheimer's disease is similar or superior to clinical cerebrospinal fluid tests}},
journal = {Nature medicine},
year = {2024},
doi = {10.1038/s41591-024-02869-z},
pmid = {38382645},
url = {https://doi.org/10.1038/s41591-024-02869-z}
}
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