Evaluation of Plasma Biomarkers for A/T/N Classification of Alzheimer Disease Among Adults of Caribbean Hispanic Ethnicity

• DOI: 10.1001/jamanetworkopen.2023.8214
• Publication Date: 2023-04-20T16:33:10Z
• Authors: Lawrence S. Honig; Min Suk Kang; Annie J. Lee; Dolly Reyes-Dumeyer; Angel Piriz; Belisa Soriano; Yahaira Franco; Zoraida Dominguez...; Patricia Recio; Diones Rivera Mejía; Martin Medrano; Rafael A. Lantigua; Andrew F. Teich; Jeffrey L. Dage; Richard Mayeux
• Keywords: Apolipoprotein E; Amyloid beta

Importance Cerebrospinal fluid (CSF) and plasma biomarkers can detect biological evidence of Alzheimer disease (AD), but their use in low-resource environments among minority ethnic groups is limited. Objective To assess validated for AD adults Caribbean Hispanic ethnicity. Design, Setting, Participants In this decision analytical modeling study, were recruited between January 1, 2018, April 30, 2022, underwent detailed clinical assessments venipuncture. A subsample participants also consented to lumbar puncture. Established CSF cut points used define biomarker-positive status, allowing determination optimal the same individuals. The performance a panel 6 was then assessed with respect entire group. Data analysis performed 2023. Main Outcomes Measures outcomes association amyloid-β 1-42 (Aβ42), 1-40 (Aβ40), total tau (T-tau), phosphorylated tau181 (P-tau181), glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL) diagnosis. These allow assessment amyloid (A), neurofibrillary degeneration (T), neurodegeneration (N) aspects AD. Statistical analyses included receiver operating characteristics, Pearson Spearman correlations, t tests, Wilcoxon rank-sum, chi-square, Fisher exact tests. Exposures age, sex, education, country residence, apolipoprotein-ε4 ( APOE-ε4 ) allele number, serum creatinine, blood urea nitrogen, body mass index. Results This study 746 adults. had mean (SD) age 71.0 (7.8) years, 480 (64.3%) women, 154 (20.6%) met criteria Associations observed P-tau181 r = .47 [95% CI, 0.32-0.60]), NfL 0.57 0.44-0.68]), P-tau181/Aβ42 0.44 0.29-0.58]). For defined by biomarkers, provided Among individuals judged be clinically healthy without dementia, status determined 133 (22.7%) 104 (17.7%). diagnosed AD, 69 (45.4%) levels 89 (58.9%) that inconsistent Individuals biomarker-negative tended have lower less likely carry alleles, GFAP than Conclusions Relevance cross-sectional measurements correctly classified However, identified dementia portion those whose biomarker profile negative. results suggest augment detection preclinical asymptomatic improve specificity