Plasma p-tau181, p-tau217, and other blood-based Alzheimer's disease biomarkers in a multi-ethnic, community study

Alzheimers Dement. 2021 Aug;17(8):1353-1364. doi: 10.1002/alz.12301. Epub 2021 Feb 13.


Introduction: Blood-based Alzheimer's disease (AD) biomarkers provide opportunities for community studies and across ethnic groups. We investigated blood biomarker concentrations in the Washington Heights-Inwood Columbia Aging Project (WHICAP), a multi-ethnic community study of aging and dementia.

Methods: We measured plasma amyloid beta (Aβ)40, Aβ42, total tau (t-tau), phosphorylated tau (p-tau)181, and p-tau217, and neurofilament light chain (NfL) in 113 autopsied participants (29% with high AD neuropathological changes) and in 300 clinically evaluated individuals (42% with clinical AD). Receiver operating characteristics were used to evaluate each biomarker. We also investigated biomarkers as predictors of incident clinical AD.

Results: P-tau181, p-tau217, and NfL concentrations were elevated in pathologically and clinically diagnosed AD. Decreased Aβ42/Aβ40 ratio and increased p-tau217 and p-tau181 were associated with subsequent AD diagnosis.

Discussion: Blood-based AD biomarker concentrations are associated with pathological and clinical diagnoses and can predict future development of clinical AD, providing evidence that they can be incorporated into multi-ethnic, community-based studies.

Keywords: Alzheimer's disease; amyloid; blood-based biomarkers; neurofilament light chain; tau.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged, 80 and over
  • Alzheimer Disease / blood*
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / ethnology*
  • Amyloid beta-Peptides / blood*
  • Autopsy
  • Biomarkers / blood*
  • Ethnicity / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Neurofilament Proteins / blood*
  • New York City
  • Phosphorylation
  • Positron-Emission Tomography
  • tau Proteins / blood*


  • Amyloid beta-Peptides
  • Biomarkers
  • Neurofilament Proteins
  • neurofilament protein L
  • tau Proteins