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Plasma biomarkers and incident clinical stage progression in the specialized memory clinic: a longitudinal study
Zeng X, Heaton N, Deek RA, Nafash MN, Farinas MF, Choity LT, Balogun WG, Shi R et al.. medRxiv, 2026-10-21
Topic: Plasma and spinal-fluid biomarkers
INTRODUCTION The utility of blood based Alzheimer’s disease (AD) biomarkers in predicting clinical trajectories remains uncertain. METHODS We assessed the diagnostic and prognostic performance of p-tau181, p-tau217, GFAP, and NfL in a large memory□clinic cohort (n=3,645) with comprehensive baseline clinical evaluation and annual follow□up for up to three decades. RESULTS P-tau217, p-tau181 and GFAP were associated with amyloid-beta (Aβ) pathology, while all biomarkers were elevated in AD and all-cause dementia. P-tau217 significantly outperformed others in detecting Aβ pathology and clinical AD but performed similarly to NfL and GFAP for all-cause dementia. Prognostically, p□tau217 demonstrated the strongest association with cognitive decline, followed by GFAP and NfL, and best predicted progression status at 5□ and 10□ year intervals. All biomarkers provided added prognostic value beyond demographic and genetic covariates. DISCUSSION These findings support plasma biomarkers for disease identification and risk stratification while underscoring the need for population□specific approaches.
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APA 7th
Zeng, X., Heaton, N., Deek, R. A., Nafash, M. N., Farinas, M. F., Choity, L. T., et al. (2026). Plasma biomarkers and incident clinical stage progression in the specialized memory clinic: a longitudinal study. medRxiv. https://doi.org/10.64898/2026.10.19.26365317
Vancouver
Zeng X, Heaton N, Deek RA, Nafash MN, Farinas MF, Choity LT, et al. Plasma biomarkers and incident clinical stage progression in the specialized memory clinic: a longitudinal study. medRxiv. 2026. doi:10.64898/2026.10.19.26365317.
BibTeX
@article{zeng2026-7d89c156,
author = {Zeng, X. and Heaton, N. and Deek, R. A. and Nafash, M. N. and Farinas, M. F. and Choity, L. T. and Balogun, W. G. and Shi, R. and others},
title = {{Plasma biomarkers and incident clinical stage progression in the specialized memory clinic: a longitudinal study}},
journal = {medRxiv},
year = {2026},
doi = {10.64898/2026.10.19.26365317},
url = {https://doi.org/10.64898/2026.10.19.26365317}
}
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Key findings
- RESULTS P-tau217, p-tau181 and GFAP were associated with amyloid-beta (Aβ) pathology, while all biomarkers were elevated in AD and all-cause dementia.
- P-tau217 significantly outperformed others in detecting Aβ pathology and clinical AD but performed similarly to NfL and GFAP for all-cause dementia.
- Prognostically, p□tau217 demonstrated the strongest association with cognitive decline, followed by GFAP and NfL, and best predicted progression status at 5□ and 10□ year intervals.
- DISCUSSION These findings support plasma biomarkers for disease identification and risk stratification while underscoring the need for population□specific approaches.
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Study details
- Participants3,645
- Evidence strengthModerate
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 34 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for study design, effect reported and randomized / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 21 of the 62 points we could judge it on, which is 34 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| 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 | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,645 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 | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 21 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 21 of the 62 points we could judge it on is 34 out of 100. |
| Total | 34 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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