Plasma biomarkers, brain amyloid‐beta pathology, and cortical thickness in a non‐Hispanic White and Black/African American middle‐aged community cohort: The HCP‐CoBRA study

Dec 12, 2025Alzheimer's & dementia : the journal of the Alzheimer's Association

Blood markers, brain amyloid buildup, and brain thickness in middle-aged White and Black/African American adults

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Abstract

Plasma demonstrated high accuracy for identifying abnormal amyloid beta-positron emission tomography () status with an area under the curve (AUC) of 0.9198.

  • Plasma p-tau217 had sensitivity and specificity greater than 85% for Aβ-PET status.
  • All plasma biomarkers, except p-tau231, effectively ruled out Aβ pathology with a negative predictive value (NPV) exceeding 95%.
  • The Johnson & Johnson p-tau217 showed a covariate-adjusted positive predictive value (PPV) of 0.909 for confirming Aβ pathology.
  • Plasma biomarkers did not accurately identify cortical thickness despite being elevated in association with Aβ-PET and neurodegeneration profiles.
  • Correlations of p-tau217, p-tau181, and Aβ42/40 with Aβ-PET were stronger in non-Hispanic Whites compared to Black/African Americans.

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Key numbers

0.919
AUC for ALZpath
Predictive accuracy for distinguishing A+ from A– participants
0.914
AUC for Johnson & Johnson +
Predictive accuracy for distinguishing A+ from A– participants
1.33 times
Fold change of
Higher in Black/African American participants compared to non-Hispanic White participants

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