{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:11:41Z","timestamp":1790655101613,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T00:00:00Z","timestamp":1651017600000},"content-version":"vor","delay-in-days":116,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alz &amp; Dem Diag Ass &amp; Dis Mo"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Biomarker testing is recommended for the accurate and timely diagnosis of Alzheimer's disease (AD). Using illustrative case narratives we consider how cerebrospinal fluid (CSF) biomarker tests may be used in different presentations of cognitive impairment to facilitate timely and differential diagnosis, improving diagnostic accuracy, providing prognostic information, and guiding personalized management in diverse scenarios. Evidence shows that (1) CSF ratios are superior to amyloid beta (A\u03b2)1\u201042 alone; (2) concordance of CSF ratios to amyloid positron emission tomography (PET) is better than A\u03b21\u201042 alone; and (3) phosphorylated tau (p\u2010tau)\/A\u03b21\u201042 ratio is superior to p\u2010tau alone. CSF biomarkers are recommended for the exclusion of AD as the underlying cause of cognitive impairment, diagnosis of AD at an early stage, differential diagnosis of AD in individuals presenting with other neuropsychiatric symptoms, accurate diagnosis of AD in an atypical presentation, and for clinical trial enrichment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p>\u00a0<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarker testing may be underused outside specialist centers.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>CSF biomarkers improve diagnostic accuracy, guiding personalized management of AD.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>CSF ratios (amyloid beta [A\u03b2]1\u201042\/A\u03b21\u201040 and phosphorylated tau\/A\u03b21\u201042) perform better than single markers.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>CSF ratios produce fewer false\u2010negative and false\u2010positive results than individual markers.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>CSF biomarkers should be included in diagnostic work\u2010up of AD and mild cognitive impairment due to AD.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/dad2.12314","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T04:40:55Z","timestamp":1651034455000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["Clinical application of CSF biomarkers for Alzheimer's disease: From rationale to ratios"],"prefix":"10.1002","volume":"14","author":[{"given":"Femke H.","family":"Bouwman","sequence":"first","affiliation":[{"name":"Alzheimer Center Amsterdam Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni B.","family":"Frisoni","sequence":"additional","affiliation":[{"name":"University of Geneva  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sterling C.","family":"Johnson","sequence":"additional","affiliation":[{"name":"University of Wisconsin\u2010Madison, and Geriatric Research Education and Clinical Center of the William S. 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