Performance of plasma p‐tau217 and NfL in an unselected memory clinic setting

Abstract

Abstract INTRODUCTION Plasma phosphorylated tau‐217 (p‐tau217) and neurofilament light (NfL) can differentiate between different dementias in selected cohorts. We aim to test the discrimination potential of these markers in a real‐world cohort. METHODS We measured p‐tau217 (ALZpath) and NfL (Quanterix) in 415 (unselected) consecutive memory clinic patients. Biomarker levels were dichotomized as low/high to create four biomarker profiles based on p‐tau217 and NfL levels. RESULTS p‐Tau217 levels were highest in patients with Alzheimer's disease (AD) dementia, whereas NfL levels were highest in patients with frontotemporal dementia (FTD). Low p‐tau217/low NfL was associated mostly with non‐neurological diagnoses (79%), and high p‐tau217/low NfL indicated AD pathology at any stage (84%). Low p‐tau217/high NfL indicated FTD (38%) and high p‐tau217/high NfL indicated AD dementia (87%). DISCUSSION p‐Tau217 can identify AD pathology at any disease stage. NfL can differentiate FTD from other diagnoses (e.g., AD dementia). Plasma p‐tau217 and NfL can support clinical decision‐making, and we suggest using them as complements to standard clinical assessment. Highlights Phosphorylated tau‐2017 (p‐tau217) can detect Alzheimer's disease (AD) across the clinical continuum. Neurofilament light (NfL) can differentiate frontotemporal dementia (FTD) from other diagnoses (AD dementia, dementia with Lewy bodies [DLB], and Psychiatry). p‐Tau217 may detect AD co‐pathology in other diseases or dementia types (e.g., DLB). p‐Tau217 and NfL show potential for clinical implementation.

Keywords

• AD continuum
• Alzheimer's disease
• biomarker profiles
• blood‐based biomarkers
• frontotemporal dementia
• memory clinic