Frequency and longitudinal clinical outcomes of Alzheimer's AT(N) biomarker profiles: A longitudinal study

Alzheimers Dement. 2019 Sep;15(9):1208-1217. doi: 10.1016/j.jalz.2019.05.006. Epub 2019 Aug 6.


Introduction: We aimed to estimate the frequency of each AT(N) (β-amyloid deposition [A], pathologic tau [T], and neurodegeneration [N]) profile in different clinical diagnosis groups and to describe the longitudinal change in clinical outcomes of individuals in each group.

Methods: Longitudinal change in clinical outcomes and conversion risk of AT(N) profiles are assessed using linear mixed-effects models and multivariate Cox proportional-hazard models, respectively.

Results: Participants with A+T+N+ showed faster clinical progression than those with A-T-N- and A+T±N-. Compared with A-T-N-, participants with A+T+N± had an increased risk of conversion from cognitively normal (CN) to incident prodromal stage of Alzheimer's disease (AD), and from MCI to AD dementia. A+T+N+ showed an increased conversion risk when compared with A+T±N-.

Discussion: The 2018 research framework may provide prognostic information of clinical change and progression. It may also be useful for targeted recruitment of participants with AD into clinical trials.

Keywords: Alzheimer's disease; Biomarker; Prognosis; Research framework.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Alzheimer Disease* / diagnostic imaging
  • Alzheimer Disease* / pathology
  • Amyloid beta-Peptides / metabolism
  • Biomarkers*
  • Brain / pathology
  • Cross-Sectional Studies
  • Disease Progression*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Positron-Emission Tomography
  • Prodromal Symptoms*
  • Prognosis
  • tau Proteins / metabolism


  • Amyloid beta-Peptides
  • Biomarkers
  • tau Proteins

Grant support