Multi-Protein Blood Test Improves Staging of Alzheimer’s Disease

Alzheimer’s disease begins years before dementia develops, as amyloid plaques and tau pathology progressively damage neurons. Diagnosis has traditionally relied on cognitive decline, while biomarker testing has often required cerebrospinal fluid sampling or positron emission tomography (PET) imaging. Blood tests such as p-tau217 have expanded access to Alzheimer’s biomarkers, but single-analyte approaches may be less effective for staging disease or predicting progression. New findings show that measuring a broader panel of blood proteins can improve disease staging.

Researchers at the University of Gothenburg evaluated a multi-protein blood biomarker panel that includes p-tau217 to improve assessment of Alzheimer’s disease stage. The approach combines large-scale blood proteomics with machine learning to derive biomarker profiles associated with disease progression, addressing limitations of single-analyte blood tests when compared with imaging-based staging.

In the study, published in JAMA Neurology on August 10, 2026, investigators analyzed two independent international cohorts using a novel immunoassay platform capable of measuring more than 120 inflammatory and neuronal markers from a single blood sample. The researchers examined whether proteins beyond p-tau217 could improve the prediction of advanced tau pathology among individuals with elevated amyloid plaque burden.

The results showed that incorporating additional proteins significantly improved the ability of p-tau217 to predict advanced tau pathology in individuals with elevated amyloid levels. According to the researchers, the findings suggest that a multi-protein blood-based approach could provide an alternative to tau-PET for disease staging in clinical and research settings. By capturing a broader range of biological changes, the panel may also provide a more complete picture of disease progression and support more precise treatment decisions.

“We identified a panel of seven proteins, including p-tau217, that could improve the blood test's ability to determine when a patient exhibits a disease profile corresponding to a late stage. This could yield better screening results, which is particularly valuable for guiding treatment choices and recruitment for clinical trials of future treatments for Alzheimer's disease,” said Guglielmo Di Molfetta, a doctoral student in neurochemistry at the University of Gothenburg.

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