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67/100

✓ Peer-reviewed alzhub usefulness score 67 out of 100. Biomarkers

Topic: Amyloid, tau and blood-test diagnosis

Plain-language summary

Objective To compare different β-amyloid (Aβ), tau, and neurodegeneration (AT[N]) variants within the Swedish BioFINDER studies. Methods A total of 490 participants were classified into AT(N) groups. These include 53 cognitively unimpaired (CU) and 48 cognitively impaired (CI) participants (14 mild cognitive impairment [MCI] and 34 Alzheimer disease [AD] dementia) from BioFINDER-1 and 389 participants from BioFINDER-2 (245 CU and 144 CI [138 MCI and 6 AD dementia]). Biomarkers for A were CSF Aβ 42 and amyloid-PET ([ 18 F]flutemetamol); for T, CSF phosphorylated tau (p-tau) and tau PET ([ 18 F]flortaucipir); and for (N), hippocampal volume, temporal cortical thickness, and CSF neurofilament light (NfL). Binarization of biomarkers was achieved using cutoffs defined in other cohorts. The relationship between different AT(N) combinations and cognitive trajectories (longitudinal Mini-Mental State Examination scores) was examined using linear mixed modeling and coefficient of variation. Results Among CU participants, A-T-(N)- or A+T-(N)- variants were most common. However, more T+ cases were seen using p-tau than tau PET. Among CI participants, A+T+(N)+ was more common; however, more (N)+ cases were seen for MRI measures relative to CSF NfL. Tau PET best predicted longitudinal cognitive decline in CI and p-tau in CU participants. Among CI participants, continuous T (especially tau PET) and (N) measures improved the prediction of cognitive decline compared to binary measures. Conclusions Our findings show that different AT(N) variants are not interchangeable, and that optimal variants differ by clinical stage. In some cases, dichotomizing biomarkers may result in loss of important prognostic information.

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

APA 7th

Mattsson-Carlgren, N., Leuzy, A., Janelidze, S., Palmqvist, S., Stomrud, E., Strandberg, O., et al. (2020). The implications of different approaches to define AT(N) in Alzheimer disease. Neurology. https://doi.org/10.1212/wnl.0000000000009485

Vancouver

Mattsson-Carlgren N, Leuzy A, Janelidze S, Palmqvist S, Stomrud E, Strandberg O, et al. The implications of different approaches to define AT(N) in Alzheimer disease. Neurology. 2020. doi:10.1212/wnl.0000000000009485. PMID: 32398359.

BibTeX

@article{mattssoncarlgren2020-32398359,
  author  = {Mattsson-Carlgren, N. and Leuzy, A. and Janelidze, S. and Palmqvist, S. and Stomrud, E. and Strandberg, O. and Smith, R. and Hansson, O.},
  title   = {{The implications of different approaches to define AT(N) in Alzheimer disease}},
  journal = {Neurology},
  year    = {2020},
  doi     = {10.1212/wnl.0000000000009485},
  pmid    = {32398359},
  url     = {https://doi.org/10.1212/wnl.0000000000009485}
}

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 names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. 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 490 participants. Ask whether that is enough for the question, and who they were.
Effect: the record gives no effect size, so the summary above cannot say how large any difference was.

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.

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Key findings

Results Among CU participants, A-T-(N)- or A+T-(N)- variants were most common.
Among CI participants, continuous T (especially tau PET) and (N) measures improved the prediction of cognitive decline compared to binary measures.
Conclusions Our findings show that different AT(N) variants are not interchangeable, and that optimal variants differ by clinical stage.
In some cases, dichotomizing biomarkers may result in loss of important prognostic information.

Why it matters

This study found that different ways of defining the AT(N) biomarker categories are not interchangeable, and that continuous tau and neurodegeneration measures predicted cognitive decline better than binary ones in cognitively impaired participants. This is about how to classify and predict using biomarkers, not about treating, curing, or preventing Alzheimer's disease.

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Study details

Study designlongitudinal study
Participants490
Evidence strengthModerate

How this study scored 67/100

Published in a leading specialty journal, and it is a longitudinal study following the same 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 longitudinal study following the same 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	2 / 5	2020 — within 10 year(s) of the newest study here
Sample size	2 / 4	490 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	5 / 7	Cited 117 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	14.6 citations a year over 8 year(s) since 2020
Impact for its field and year	4 / 6	Cited 13.0× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	3 / 6	Cited by 13 other studies in this library
Still being cited	2 / 4	Cited 36 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	1 / 3	Lund University: institution h-index 1,119 (OpenAlex)
Multicenter collaboration	1 / 3	OpenAlex lists 2 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 32398359)
Free to read	2 / 2	Free to read
Total	67 / 100	—

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