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We evaluated the diagnostic performance of pTau217 and pTau217\/A\u03b242 measured using Simoa technology in memory-clinic cohorts from Brazil (Cog-Aging-Study,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009353) and Argentina (GeNED.ar,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009134). Here we show that both biomarkers accurately identified cerebrospinal fluid (CSF)-defined amyloid pathology in Cog-Aging-Study-Brazil and showed high concordance with clinical diagnosis across both cohorts. Classification performance was improved using two-cut-off approaches that account for diagnostic uncertainty. We further show that\n                    <jats:italic>APOE-\u03b54<\/jats:italic>\n                    , lower body mass index, and reduced kidney function were associated with higher pTau217 in Cog-Aging-Study-Brazil, whereas education also influenced biomarker levels in GeNED.ar-Argentina. African ancestry modified\n                    <jats:italic>APOE-\u03b54<\/jats:italic>\n                    effect on CSF but not plasma biomarkers. These findings support the use of plasma pTau217-based biomarkers in genetically admixed South American populations and in settings with limited access to CSF testing and brain imaging.\n                  <\/jats:p>","DOI":"10.1038\/s41467-026-76434-2","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T13:11:20Z","timestamp":1786021880000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic performance of plasma pTau217 in genetically admixed South American populations"],"prefix":"10.1038","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1067-1495","authenticated-orcid":false,"given":"Pamela V.","family":"Martino-Adami","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joice","family":"Coutinho de 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