{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T22:04:30Z","timestamp":1789596270047,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82327809"],"award-info":[{"award-number":["82327809"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Plasma phosphorylated tau 217 (p\u2010tau217) has emerged as a promising Alzheimer's disease (AD) biomarker, yet its longitudinal associations with neurodegeneration and cognitive decline remain inadequately characterized in Chinese populations, and ethnicity\u2010specific diagnostic thresholds are lacking for optimal clinical application.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 541 participants (402 cognitively unimpaired [CU]; 139 cognitively impaired [CI]) from the Sino Longitudinal Study on Cognitive Decline (SILCODE) cohort were enrolled. Cross\u2010sectional and longitudinal associations of plasma p\u2010tau217 with amyloid\u2010\u03b2 (A\u03b2) pathology, neurodegeneration, and cognition were evaluated. Diagnostic thresholds were derived using receiver operating characteristic analysis, and Cox regression assessed prognostic value for clinical progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Cross\u2010sectionally, baseline p\u2010tau217 was associated with greater A\u03b2 burden, neurodegeneration, and poorer cognition in the whole cohort and CI group; in the CU group, associations were confined to amyloid measures. Longitudinally, accelerated p\u2010tau217 accumulation was associated with faster neurodegeneration and cognitive decline in the whole cohort, with stage\u2010dependent patterns: nominal associations with neurodegenerative markers in CU and prominent cognitive associations in CI. Plasma p\u2010tau217 demonstrated high diagnostic accuracy for amyloid positivity (AUC\u2009=\u20090.891; cutoff: 0.529\u2009pg\/mL). Threshold\u2010based stratification effectively differentiated individuals by A\u03b2 burden, neurodegeneration, and cognitive trajectories. Elevated baseline p\u2010tau217 predicted higher progression risk (Whole cohort: HR\u2009=\u20092.66 [1.28\u20135.53],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009; CU: HR\u2009=\u20092.44 [1.07\u20135.59],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Plasma p\u2010tau217 serves as a valuable diagnostic and prognostic biomarker for AD, even among CU individuals, and the ethnicity\u2010specific threshold of 0.529\u2009pg\/mL enhances its clinical applicability for early detection and risk stratification in Chinese populations.<\/jats:p>\n                  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