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Baseline %p\u2010tau217 levels were quantified by mass spectrometry and stratified into four strata using previously defined cut\u2010offs. Outcomes included longitudinal changes in cognition, neurodegeneration, and progression to mild cognitive impairment (MCI)\/dementia. Results were replicated with immunoassays in the same and an independent primary care cohort (\n                      <jats:italic>n\u00a0=<\/jats:italic>\n                      \u00a01204).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Participants with Elevated\/High %p\u2010tau217 exhibited accelerated cognitive decline, hippocampal atrophy, and significantly higher risks of progression to MCI (hazard ratio [HR]\u00a0&gt;\u00a06.0) and dementia (HR\u00a0&gt;\u00a09.9). The Low group demonstrated a 92.2% 10\u2010year negative predictive value for any progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Our results suggest that %p\u2010tau217 is a robust prognostic biomarker, accurately distinguishing CU individuals at minimal risk from those at high risk of future AD\u2010related clinical and neurodegenerative decline. Similar performance was achieved by immunoassays.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71599","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T11:00:36Z","timestamp":1784718036000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic value of plasma %p\u2010tau217 in cognitively unimpaired older adults"],"prefix":"10.1002","volume":"22","author":[{"given":"Jes\u00fas","family":"Silva\u2010Rodr\u00edguez","sequence":"first","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Zhang","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Kleineidam","sequence":"additional","affiliation":[{"name":"Department of Old Age Psychiatry and Cognitive Disorders University Hospital Bonn  Bonn Germany"},{"name":"German Center for Neurodegenerative Diseases (DZNE)  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco J.","family":"L\u00f3pez\u2010Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Wagner\u2010Reguero","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minerva","family":"Mart\u00ednez\u2010Castillo","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda 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Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ruiz\u2010Calvo","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"S\u00e1nchez\u2010Mart\u00edn","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Alfayate","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Molero\u2010Cart\u00f3n","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth L.","family":"Valeriano\u2010Lorenzo","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bel\u00e9n","family":"Frades\u2010Payo","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meritxell","family":"Valent\u00ed","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda A.","family":"Zea\u2010Sevilla","sequence":"additional","affiliation":[{"name":"Reina Sof\u00eda Foundation Alzheimer Centre CIEN Foundation, ISCIII  Madrid 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of Psychiatry Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases  San Antonio Texas USA"},{"name":"Cluster of Excellence Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Martino\u2010Adami","sequence":"additional","affiliation":[{"name":"Division of Neurogenetics and Molecular Psychiatry Department of Psychiatry and Psychotherapy Faculty of Medicine and University Hospital Cologne University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffi G.","family":"Riedel\u2010Heller","sequence":"additional","affiliation":[{"name":"Institute of Social Medicine Occupational Health and Public Health University of Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Scherer","sequence":"additional","affiliation":[{"name":"Department of 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