{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T19:37:10Z","timestamp":1792870630429,"version":"4.5.0"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alzheimer's disease (AD) has evolved from a syndromic diagnosis to a biologically defined entity supported by cerebrospinal fluid (CSF) biomarkers. The Alzheimer's Association 2024 (AA-2024) criteria are expected to expand biological AD classification compared with the 2018 NIA\u2013AA AT(N) framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare biological AD classification using the AT(N) 2018 framework and the AA-2024 criteria in a real-world cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective study including 146 consecutive patients evaluated for cognitive impairment in a tertiary neurology center who underwent CSF biomarker testing (A\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      , A\u03b2\n                      <jats:sub>40<\/jats:sub>\n                      , A\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      \/A\u03b2\n                      <jats:sub>40<\/jats:sub>\n                      ratio, phosphorylated tau, and total tau). Each patient was classified according to AT(N) 2018 and AA-2024 criteria. Diagnostic distributions, reclassification patterns, and agreement (Cohen's \u03ba) were analyzed. Group comparisons used Wilcoxon rank-sum and Fisher's exact tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Under AT(N) 2018, 40\/146 (27.4%) patients met biological AD criteria, whereas AA-2024 classified 72\/146 (49.3%) as AD. Reclassification occurred exclusively from non-AD to AD (32 patients, 21.9%), with no reverse reclassification. Agreement was moderate (\u03ba\u2009=\u20090.57). Concordant AD cases (AD+\/AD+) showed lower A\u03b2\n                      <jats:sub>42<\/jats:sub>\n                      \/A\u03b2\n                      <jats:sub>40<\/jats:sub>\n                      ratios and higher total and phosphorylated tau levels than reclassified cases (AD\u2212\/AD+) (all p\u2009&lt;\u20090.001), as well as higher neurodegeneration marker positivity (70% versus 25%; p\u2009&lt;\u20090.001). Final clinical AD diagnosis was assigned to 98% of concordant cases versus 38% of reclassified cases (p\u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AA-2024 increases biological AD classification by identifying amyloid-positive individuals with lower tau burden and clinical heterogeneity, underscoring the need to integrate biomarker-based definitions with clinical and longitudinal assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261494512","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:36:19Z","timestamp":1792676179000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic reclassification under the AA-2024 biological framework: A real-world comparison with ATN 2018 using cerebrospinal fluid biomarkers"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9534-5340","authenticated-orcid":false,"given":"Caio Viana","family":"Botelho","sequence":"first","affiliation":[{"name":"Hospital Geral de Fortaleza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1878-3424","authenticated-orcid":false,"given":"Amandha","family":"Carneiro","sequence":"additional","affiliation":[{"name":"Hospital Geral de Fortaleza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4117-8991","authenticated-orcid":false,"given":"Carolina","family":"Regadas","sequence":"additional","affiliation":[{"name":"Hospital Geral de Fortaleza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5211-7210","authenticated-orcid":false,"given":"Cintia","family":"Cavalcante","sequence":"additional","affiliation":[{"name":"Hospital Geral de Fortaleza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Hospital Geral de Fortaleza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5926-0685","authenticated-orcid":false,"given":"Samia","family":"Rabelo","sequence":"additional","affiliation":[{"name":"Hospital Geral de Fortaleza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vania","family":"Araujo","sequence":"additional","affiliation":[{"name":"Hospital Geral de Fortaleza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6733-8803","authenticated-orcid":false,"given":"Glauber","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Hospital Geral de Fortaleza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6828-9600","authenticated-orcid":false,"given":"Bruno Di\u00f3genes","family":"Iepsen","sequence":"additional","affiliation":[{"name":"Hospital Geral de Fortaleza"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2828-5664","authenticated-orcid":false,"given":"Norberto Anizio","family":"Ferreira Frota","sequence":"additional","affiliation":[{"name":"Hospital Geral de Fortaleza"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70133"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2018.05.006"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2018.02.018"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410380413"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(03)00530-1"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2018.01.010"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrd2176"},{"key":"e_1_3_3_9_2","article-title":"Comparing CSF amyloid-beta biomarker ratios with amyloid PET status","volume":"13","author":"Willemse EAJ","year":"2021","unstructured":"Willemse EAJ, Tijms BM, van Berckel BNM, et al. 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