Advances in Blood-Based Diagnostics for Alzheimer’s Disease: Clinical Implications and Biomarker Integration

Abstract

Ashel Rovita Lobo and Karunakar Hegde

Alzheimer's disease (AD), the leading cause of dementia, presents important diagnostic difficulties with its subtle onset and limitation of traditional diagnostic methods such as cerebrospinal fluid (CSF) examination and PET scanning. These accurate methods are still invasive, costly, and mostly unavailable in the primary care environment. It is only recently that blood-based biomarkers have been the focus, targeting important pathological aspects of AD amyloid load, tau pathology, neuroinflammation, and neurodegeneration. By 2025, plasma biomarkers including phosphorylated tau (p-tau217), amyloid-β 42/40 ratio, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) have shown diagnostic accuracies greater than 90%, with FDA-cleared systems such as Lumipulse found in clinical practice. Such advances are transforming the diagnostics landscape allowing early detection, risk stratification, and monitoring therapeutic response in a minimally invasive and cost-efficient manner. Platforms like SIMOA, mass spectrometry, and future point-of-care biosensors enable research and clinical deployment. With their potential, however, comes difficulty in standardizing assays, validating them in population-specific contexts, ensuring ethical application, and making them available. In the future, AI-driven multimarker panels, home-testing solutions, and international policy endorsement might make Alzheimer's diagnostics more democratized. Blood-based biomarkers therefore constitute an AD care paradigm shift that holds promise for earlier intervention and better outcomes across a variety of healthcare settings

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