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Biomarkers are needed to monitor BBB integrity over time, better understand the role of the BBB in neurodegeneration, potentially help define long\u2010term ADRD risk, and monitor effects of therapeutics. In this review, we discuss the current biomarkers used to detect human BBB dysfunction in the context of cognitive decline and dementia. We also discuss promising candidate fluid biomarkers to detect BBB dysfunction in blood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>BBB permeability occurs during normal aging and is further exacerbated in ADRD.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>In this review, we discuss in vivo imaging and CSF biomarkers of BBB dysfunction currently used in the setting of aging and ADRD in humans.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>We also review promising candidate blood\u2010based biomarkers that may represent BBB dysfunction.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70104","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T00:06:58Z","timestamp":1743293218000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Biomarkers of blood\u2013brain barrier and neurovascular unit integrity in human cognitive impairment and dementia"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1747-949X","authenticated-orcid":false,"given":"Scott R.","family":"French","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery University of Arizona  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Briana P.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Radiology, Integrated Brain Imaging Center University of 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