Risk of Alzheimer's Disease is Associated with Longitudinal Changes in Plasma Biomarkers in the Multiethnic Washington Heights, Inwood Columbia Aging Project Cohort.

Systematic Review: Few studies have evaluated the clinical application of AD blood-based biomarkers longitudinally as antecedent risk predictors. Data from multiethnic populations are even more limited. How preclinical trajectories of blood-based biomarkers are related with the risk of developing clinically diagnosed MCI or AD is largely unknown.Interpretation: High circulating level of P-tau181/Aβ42, by itself or combined with a low level of Aβ42/Aβ40, may predict development of incident clinical AD. Biomarkers levels of P-tau181, P-tau181/Aβ42, and NfL increase with age even among individuals who remain cognitively healthy. A rapid change in biomarkers may indicate the individuals in the active trajectory to develop clinically diagnosed MCI or AD.Future Directions: Larger studies or meta-analyses are needed to examine whether the predictive utility of blood-based biomarkers for AD differs across racial/ethnic groups. Well-designed studies are needed to evaluate the optimal duration between repeated measures of biomarkers.