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Here we share our experience of running a clinical cognitive CSF service and discuss recent developments in laboratory testing including the use of the CSF amyloid-\u03b2 42\/40 ratio and automated assay platforms. We highlight the importance of collaborative working between clinicians and laboratory staff, of preanalytical sample handling, and discuss the various factors influencing interpretation of the results in appropriate clinical contexts. We advocate for broadening access to CSF biomarkers by sharing clinical expertise, protocols and interpretation with colleagues working in psychiatry and elderly care, especially when access to CSF may be part of a pathway to disease-modifying treatments for Alzheimer\u2019s disease and other forms of dementia.<\/jats:p>","DOI":"10.1136\/practneurol-2021-003310","type":"journal-article","created":{"date-parts":[[2022,3,17]],"date-time":"2022-03-17T13:34:57Z","timestamp":1647524097000},"page":"285-294","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["CSF biomarkers for dementia"],"prefix":"10.1136","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1043-5721","authenticated-orcid":false,"given":"Ashvini","family":"Keshavan","sequence":"first","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frankie","family":"O\u2019Shea","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miles D","family":"Chapman","sequence":"additional","affiliation":[{"name":"Neuroimmunology and CSF Laboratory, National Hospital for Neurology and Neurosurgery, London, UK"},{"name":"Department of Neuroinflammation, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie S","family":"Hart","sequence":"additional","affiliation":[{"name":"Neuroimmunology and CSF Laboratory, National Hospital for Neurology and Neurosurgery, London, UK"},{"name":"Department of Neuroinflammation, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3174-6027","authenticated-orcid":false,"given":"Michael PT","family":"Lunn","sequence":"additional","affiliation":[{"name":"Neuroimmunology and CSF Laboratory, National Hospital for Neurology and Neurosurgery, London, UK"},{"name":"MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9372-3635","authenticated-orcid":false,"given":"Ross W","family":"Paterson","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6155-8417","authenticated-orcid":false,"given":"Jonathan D","family":"Rohrer","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, University College London Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine J","family":"Mummery","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6660-657X","authenticated-orcid":false,"given":"Nick C","family":"Fox","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3930-4354","authenticated-orcid":false,"given":"Henrik","family":"Zetterberg","sequence":"additional","affiliation":[{"name":"Fluid Biomarkers Laboratory, UK DRI at University College London, UK Dementia Research Institute, London, UK"},{"name":"Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2059-024X","authenticated-orcid":false,"given":"Jonathan M","family":"Schott","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,3,17]]},"reference":[{"key":"2025090410583481000_22.4.285.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(16)00070-3"},{"key":"2025090410583481000_22.4.285.2","unstructured":"Alzbiomarker database, version 3.0: Alzforum, 2021. 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Are we ready to deliver disease modifying treatments? Old Age Psychiatrists\u2019 views on diagnosing and treating Alzheimer\u2019s disease before dementia, 2021. 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