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Prognostic Value of Blood-Based P-Tau217 Levels for Progression to Cognitive Impairment
Rachel F Buckley, Diana L Townsend, Colin J Birkenbihl, Madison Cuppels, Gillian T Coughlan, Mabel T Seto, Jane A Brown, Michael J Properzi, et al.. JAMA, 2026-09-15
Topic: Amyloid, tau and blood-test diagnosis
Results Among the 2684 participants (median [IQR] age, 69.6 [66.2-74.2] years; 1697 [63%] female), there were 478 events of progression to cognitive impairment over a median follow-up of 5.4 years (maximum follow-up of 13.5 years). Each 1-SD increase in baseline p-tau217 level was associated with an increased risk of progression to cognitive impairment (hazard ratio, 1.38 [95% CI, 1.30-1.46]), and the association remained significant after adjustment, including β-amyloid positron emission tomography scan Centiloids (hazard ratio, 1.32 [95% CI, 1.24-1.41]). Elevated p-tau217 was also associated with faster cognitive decline based on change in latent PACC score. Among the overall sample, baseline latent PACC scores ranged from -0.8 to 2.7. Conclusions and relevance In a pooled sample of multiple selected cohorts of cognitively unimpaired older adults, higher plasma p-tau217 levels were consistently associated with increased risk of clinical progression and accelerated cognitive decline. By providing time-specific absolute risk estimates, these findings support the potential of p-tau217 for prognostic model development, with direct implications for future trial design.
Key findings
- Results Among the 2684 participants (median [IQR] age, 69.6 [66.2-74.2] years; 1697 [63%] female), there were 478 events of progression to cognitive impairment over a median follow-up of 5.4 years (maximum follow-up of 13.5 years).
- Each 1-SD increase in baseline p-tau217 level was associated with an increased risk of progression to cognitive impairment (hazard ratio, 1.38 [95% CI, 1.30-1.46]), and the association remained significant after adjustment, including β-amyloid positron emission tomography scan Centiloids (hazard ratio, 1.32 [95% CI, 1.24-1.41]).
- Elevated p-tau217 was also associated with faster cognitive decline based on change in latent PACC score.
- Among the overall sample, baseline latent PACC scores ranged from -0.8 to 2.7.
- Conclusions and relevance In a pooled sample of multiple selected cohorts of cognitively unimpaired older adults, higher plasma p-tau217 levels were consistently associated with increased risk of clinical progression and accelerated cognitive decline.
Why it matters
In this pooled analysis of older adults without cognitive impairment, higher baseline blood p-tau217 levels were linked to a higher risk of progressing to cognitive impairment and faster cognitive decline. The authors say this supports using p-tau217 in prognostic models and future trial design.
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Study details
- Study designcohort
- Participants2,684
- Effect sizeHazard ratio 1.38 (95% CI 1.30-1.46) per 1-SD baseline p-tau217 for progression to cognitive impairment; 5-year absolute risk 38% (95% CI 33-43) in the very-high group
- Evidence strengthHigh
Limitations
Selected research cohorts, not an unselected population, so absolute risks may not apply to the general public; longer-term (10-year) estimates rest on limited data; different assays across cohorts were harmonised statistically.
How this study scored 67/100
Published in a top-tier journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it. We have no data on free to read, so that was left out: it earned 66 of the 98 points we could judge it on, which is 67 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 3 / 4 | 2,684 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| 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 4 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 4 / 6 | Cited 18.9× 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 | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Shelley Moore: h-index 14 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 13 institution(s) in 4 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42449500) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 66 / 98 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 66 of the 98 points we could judge it on is 67 out of 100. |
| Total | 67 / 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
Buckley, R. F., Townsend, D. L., Birkenbihl, C. J., Cuppels, M., Coughlan, G. T., Seto, M. T., et al. (2026). Prognostic Value of Blood-Based P-Tau217 Levels for Progression to Cognitive Impairment. JAMA. https://doi.org/10.1001/jama.2026.12556
Vancouver
Buckley RF, Townsend DL, Birkenbihl CJ, Cuppels M, Coughlan GT, Seto MT, et al. Prognostic Value of Blood-Based P-Tau217 Levels for Progression to Cognitive Impairment. JAMA. 2026. doi:10.1001/jama.2026.12556. PMID: 42449500.
BibTeX
@article{buckley2026-42449500,
author = {Buckley, Rachel F and Townsend, Diana L and Birkenbihl, Colin J and Cuppels, Madison and Coughlan, Gillian T and Seto, Mabel T and Brown, Jane A and Properzi, Michael J and others},
title = {{Prognostic Value of Blood-Based P-Tau217 Levels for Progression to Cognitive Impairment}},
journal = {JAMA},
year = {2026},
doi = {10.1001/jama.2026.12556},
pmid = {42449500},
url = {https://doi.org/10.1001/jama.2026.12556}
}
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