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Diagnostic performance of Alzheimer’s disease blood and CSF biomarkers in a Brazilian cohort with low educational attainment

Molecular Psychiatry volume 30, pages 6090–6098 (2025) Cite this article

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Abstract

Blood-based biomarkers (BBMs) have emerged as promising tools to enhance Alzheimer’s disease (AD) diagnosis. Despite two-thirds of dementia cases occurring in the Global South, research on BBMs has predominantly focused on populations from the Global North. This geographical disparity hinders our understanding of BBM performance in diverse populations. To address this, we evaluated the diagnostic properties of AD BBMs in a real-world memory clinic from Brazil, one of the largest countries in the Global South. We measured blood and cerebrospinal fluid (CSF) biomarkers - amyloid-β (Aβ)40, Aβ42, phosphorylated tau (p-tau) 217, neurofilament light (NfL) chain, and glial fibrillary acidic protein (GFAP) - in 59 individuals. Sample comprised 20 cognitively unimpaired (CU) individuals, 22 with AD dementia, and 17 with vascular dementia (VaD). We compared BBM levels across diagnostic groups and assessed their discriminative ability for AD. Notably, individuals with VaD and AD had lower educational levels (6.8 ± 3.0) compared to CU individuals (17.3 ± 6.9). Among the BBMs tested, plasma p-tau217 demonstrated the best performance, exhibiting high accuracy in differentiating CU from AD (AUC 0.96) and Aβ pathology (AUC 0.98). However, the ability of AD BBMs to distinguish between AD and VaD was lower than expected (AUC from 0.52–0.79), particularly when compared to studies from the Global North. Our findings highlight the potential utility of BBMs for AD diagnosis in real-world settings within Brazil. However, they also underscore the need for proper implementation and validation of these biomarkers within these populations to ensure accurate and reliable results.

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Fig. 1: Correlation between plasma biomarkers and clinical variables.
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Fig. 2: Plasma and CSF biomarkers levels distribution across clinical diagnosis.
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Fig. 3: Plasma biomarker levels according to Aβ status.
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Fig. 4: Diagnostic performance of biomarkers across clinical diagnosis.
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References

  1. Zhang Q, Deng Y, Xue M, Ni Z, Luo G, Tian K. Global trends in Alzheimer's disease and other dementias in adults aged 55 and above (1992-2021): An age-period-cohort analysis based on the GBD 2021. PLoS One. 2025;20:e0331204.

  2. Jack CR Jr, Therneau TM, Weigand SD, Wiste HJ, Knopman DS, Vemuri P, et al. Prevalence of biologically vs clinically defined alzheimer spectrum entities using the National Institute on Aging–Alzheimer’s Association Research Framework. JAMA Neurol. 2019;76:1174–83.

    PubMed  PubMed Central  Google Scholar 

  3. Sexton C, Snyder HM, Chandrasekaran L, Worley S, Carrillo MC. Expanding representation of low and middle income countries in global dementia research: commentary from the Alzheimer’s association. Front Neurol. 2021;12:633777.

    PubMed  PubMed Central  Google Scholar 

  4. Alladi S, Hachinski V. World dementia: one approach does not fit all. Neurology. 2018;91:264–70.

    PubMed  Google Scholar 

  5. Beach TG, Monsell SE, Phillips LE, Kukull W. Accuracy of the clinical diagnosis of Alzheimer disease at National Institute on Aging Alzheimer Disease Centers, 2005–2010. J Neuropathol Exp Neurol. 2012;71:266–73.

    PubMed  Google Scholar 

  6. Bieger A, Brum WS, Borelli WV, Therriault J, De Bastiani MA, Moreira AG, et al. Influence of different diagnostic criteria on Alzheimer disease clinical research. Neurology. 2024;103:e209753.

    PubMed  PubMed Central  Google Scholar 

  7. McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR Jr., Kawas CH, et al. The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011;7:263–9.

    PubMed  Google Scholar 

  8. Rabinovici GD, Selkoe DJ, Schindler SE, Aisen P, Apostolova LG, Atri A, et al. Donanemab: appropriate use recommendations. J Prev Alzheimers Dis. 2025;12:100150.

    PubMed  PubMed Central  CAS  Google Scholar 

  9. Custodio N, Allegri R, Lopera F, Caramelli P. Need to adapt Alzheimer’s disease criteria in Latin America. Alzheimers Dement. 2024;20:8206–8.

    PubMed  PubMed Central  Google Scholar 

  10. Hansson O. Biomarkers for neurodegenerative diseases. Nat Med. 2021;27:954–63.

    PubMed  CAS  Google Scholar 

  11. McGlinchey E, Duran-Aniotz C, Akinyemi R, Arshad F, Zimmer ER, Cho H, et al. Biomarkers of neurodegeneration across the Global South. Lancet Healthy Longev. 2024;5:100616.

    PubMed  PubMed Central  Google Scholar 

  12. Contador J, Vargas-Martínez AM, Sánchez-Valle R, Trapero-Bertran M, Lladó A. Cost-effectiveness of Alzheimer’s disease CSF biomarkers and amyloid-PET in early-onset cognitive impairment diagnosis. Eur Arch Psychiatry Clin Neurosci. 2023;273:243–52.

    PubMed  Google Scholar 

  13. Petersen RC. Are plasma markers for Alzheimer’s disease ready for clinical use? Nat Aging. 2022;2:94–96.

    PubMed  Google Scholar 

  14. Hansson O, Blennow K, Zetterberg H, Dage J. Blood biomarkers for Alzheimer’s disease in clinical practice and trials. Nat Aging. 2023;3:506–19.

    PubMed  PubMed Central  Google Scholar 

  15. Ferreira P, Ferrari-Souza JP, Tissot C, Bellaver B, Leffa D, Lussier F, et al. Potential utility of plasma P-Tau and neurofilament light chain as surrogate biomarkers for preventive clinical trials. Neurology. 2023;101:38–45.

    PubMed  PubMed Central  CAS  Google Scholar 

  16. Therriault J, Benedet AL, Pascoal TA, Lussier FZ, Tissot C, Karikari TK, et al. Association of plasma P-tau181 with memory decline in non-demented adults. Brain Commun. 2021;3:fcab136.

    PubMed  PubMed Central  Google Scholar 

  17. Brum WS, Cullen NC, Janelidze S, Ashton NJ, Zimmer ER, Therriault J, et al. A two-step workflow based on plasma p-tau217 to screen for amyloid β positivity with further confirmatory testing only in uncertain cases. Nat Aging. 2023;3:1079–90.

    PubMed  PubMed Central  CAS  Google Scholar 

  18. Karikari TK, Ashton NJ, Brinkmalm G, Brum WS, Benedet AL, Montoliu-Gaya L, et al. Blood phospho-tau in Alzheimer disease: analysis, interpretation, and clinical utility. Nat Rev Neurol. 2022;18:400–18.

    PubMed  CAS  Google Scholar 

  19. Ferreira PCL, Therriault J, Tissot C, Ferrari-Souza JP, Benedet AL, Povala G, et al. Plasma p-tau231 and p-tau217 inform on tau tangles aggregation in cognitively impaired individuals. Alzheimers Dement. 2023;19:4463–74.

    PubMed  CAS  Google Scholar 

  20. Therriault J, Brum WS, Trudel L, Macedo AC, Bitencourt FV, Martins-Pfeifer CC, et al. Blood phosphorylated tau for the diagnosis of Alzheimer’s disease: a systematic review and meta-analysis. Lancet Neurol. 2025;24:740–52.

  21. Therriault J, Vermeiren M, Servaes S, Tissot C, Ashton NJ, Benedet AL, et al. Association of phosphorylated tau biomarkers with amyloid positron emission tomography vs tau positron emission tomography. JAMA Neurol. 2022. 80. https://doi.org/10.1001/jamaneurol.2022.4485.

  22. Palmqvist S, Tideman P, Mattsson-Carlgren N, Schindler SE, Smith R, Ossenkoppele R, et al. Blood biomarkers to detect Alzheimer disease in primary care and secondary care. JAMA. 2024;332:1245–57.

    PubMed  PubMed Central  CAS  Google Scholar 

  23. Barthélemy NR, Salvadó G, Schindler SE, He Y, Janelidze S, Collij LE, et al. Highly accurate blood test for Alzheimer’s disease is similar or superior to clinical cerebrospinal fluid tests. Nat Med. 2024;30:1085–95.

    PubMed  PubMed Central  Google Scholar 

  24. Therriault J, Servaes S, Tissot C, Rahmouni N, Ashton NJ, Benedet AL, et al. Equivalence of plasma p-tau217 with cerebrospinal fluid in the diagnosis of Alzheimer’s disease. Alzheimers Dement. 2023;19:4967–77.

    PubMed  CAS  Google Scholar 

  25. Sachdev P, Kalaria R, O’Brien J, Skoog I, Alladi S, Black SE, et al. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement. Alzheimer Dis Assoc Disord. 2014;28:206–18.

    PubMed  PubMed Central  CAS  Google Scholar 

  26. Morris JC. The clinical dementia rating (CDR): current version and scoring rules. Neurology. 1993;43:2412–4.

    PubMed  CAS  Google Scholar 

  27. Budd Haeberlein S, Aisen PS, Barkhof F, Chalkias S, Chen T, Cohen S, et al. Two randomized phase 3 studies of aducanumab in early Alzheimer’s disease. J Prev Alzheimers Dis. 2022;9:197–210.

    PubMed  CAS  Google Scholar 

  28. Ashton NJ, Brum WS, Di Molfetta G, Benedet AL, Arslan B, Jonaitis E, et al. Diagnostic accuracy of a plasma phosphorylated tau 217 immunoassay for Alzheimer disease pathology. JAMA Neurol. 2024;81:255–63.

    PubMed  PubMed Central  Google Scholar 

  29. Pilotto A, Quaresima V, Trasciatti C, Tolassi C, Bertoli D, Mordenti C, et al. Plasma p-tau217 in Alzheimer’s disease: lumipulse and ALZpath SIMOA head-to-head comparison. Brain. 2025;148:408–15.

    PubMed  Google Scholar 

  30. Gobom J, Parnetti L, Rosa-Neto P, Vyhnalek M, Gauthier S, Cataldi S, et al. Validation of the LUMIPULSE automated immunoassay for the measurement of core AD biomarkers in cerebrospinal fluid. Clin Chem Lab Med. 2022;60:207–19.

    PubMed  CAS  Google Scholar 

  31. Karikari TK, Pascoal TA, Ashton NJ, Janelidze S, Benedet AL, Rodriguez JL, et al. Blood phosphorylated tau 181 as a biomarker for Alzheimer’s disease: a diagnostic performance and prediction modelling study using data from four prospective cohorts. Lancet Neurol. 2020;19:422–33.

    PubMed  CAS  Google Scholar 

  32. Da Ros LU, Borelli WV, Aguzzoli CS, De Bastiani MA, Schilling LP, Santamaria-Garcia H, et al. Social and health disparities associated with healthy brain ageing in Brazil and in other Latin American countries. Lancet Global Health. 2025;13:e277–e284.

    PubMed  Google Scholar 

  33. Prince M, Acosta D, Ferri CP, Guerra M, Huang Y, Llibre Rodriguez JJ, et al. Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: a 10/66 Dementia Research Group population-based cohort study. Lancet. 2012;380:50–58.

    PubMed  PubMed Central  Google Scholar 

  34. Pandey N, Yang Z, Cieza B, Reyes-Dumeyer D, Kang MS, Montesinos R, et al. Plasma phospho-tau217 as a predictive biomarker for Alzheimer’s disease in a large south American cohort. Alzheimers Res Ther. 2025;17:1.

    PubMed  PubMed Central  CAS  Google Scholar 

  35. Stern Y. Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol. 2012;11:1006–12.

    PubMed  PubMed Central  Google Scholar 

  36. van Loenhoud AC, van der Flier WM, Wink AM, Dicks E, Groot C, Twisk J, et al. Cognitive reserve and clinical progression in Alzheimer disease: a paradoxical relationship. Neurology. 2019;93:e334–e346.

    PubMed  PubMed Central  Google Scholar 

  37. Arenaza-Urquijo EM, Bejanin A, Gonneaud J, Wirth M, La Joie R, Mutlu J, et al. Association between educational attainment and amyloid deposition across the spectrum from normal cognition to dementia: neuroimaging evidence for protection and compensation. Neurobiol Aging. 2017;59:72–79.

    PubMed  CAS  Google Scholar 

  38. Chatterjee P, Pedrini S, Doecke JD, Thota R, Villemagne VL, Doré V, et al. Plasma Aβ42/40 ratio, p-tau181, GFAP, and NfL across the Alzheimer’s disease continuum: A cross-sectional and longitudinal study in the AIBL cohort. Alzheimers Dement. 2023;19:1117–34.

    PubMed  CAS  Google Scholar 

  39. Limberger C, Zimmer ER. Blood GFAP reflects astrocyte reactivity to Alzheimer’s pathology in post-mortem brain tissue. Brain. 2024;147:1598–1600.

    PubMed  Google Scholar 

  40. Ashton NJ, Janelidze S, Al Khleifat A, Leuzy A, van der Ende EL, Karikari TK, et al. A multicentre validation study of the diagnostic value of plasma neurofilament light. Nat Commun. 2021;12:3400.

    PubMed  PubMed Central  CAS  Google Scholar 

  41. Sheth U, Öijerstedt L, Heckman MG, White LJ, Heuer HW, Lario Lago A, et al. Comprehensive cross-sectional and longitudinal comparisons of plasma glial fibrillary acidic protein and neurofilament light across FTD spectrum disorders. Mol Neurodegener. 2025;20:30.

    PubMed  PubMed Central  CAS  Google Scholar 

  42. Benoist C, Weidner W, Barbarino P, Appleton-Sas R, Arthurton L, Mantineo G, et al. Alzheimer’s Disease International. From Plan to Impact VII: Dementia at a Crossroads. London: Alzheimer’s Disease International; 2024.

  43. Jack CR Jr., Andrews JS, Beach TG, Buracchio T, Dunn B, Graf A, et al. Revised criteria for diagnosis and staging of Alzheimer’s disease: Alzheimer’s Association Workgroup. Alzheimers Dement. 2024;20:5143–69.

    PubMed  PubMed Central  Google Scholar 

  44. Santos LE, Mattos P, Pinheiro TL, Silva A, Drummond C, Sudo FK, et al. Performance of plasma biomarkers for diagnosis and prediction of dementia in a Brazilian cohort. Nat Commun. 2025;16:2911.

    PubMed  PubMed Central  CAS  Google Scholar 

  45. Janelidze S, Teunissen CE, Zetterberg H, Allué JA, Sarasa L, Eichenlaub U, et al. Head-to-Head comparison of 8 plasma amyloid-β 42/40 assays in Alzheimer disease. JAMA Neurol. 2021;78:1375–82.

    PubMed  Google Scholar 

  46. Bellaver B, Puig-Pijoan A, Ferrari-Souza JP, Leffa DT, Lussier FZ, Ferreira PCL, et al. Blood-brain barrier integrity impacts the use of plasma amyloid-β as a proxy of brain amyloid-β pathology. Alzheimers Dement. 2023;19:3815–25.

    PubMed  CAS  Google Scholar 

  47. Barbosa B, Souza-Talarico JN, Jesus MCF, Mota GPS, Oliveira MO, Cassimiro L, et al. Allostatic load measures in older adults with subjective cognitive decline and mild cognitive impairment: a cross-sectional analysis from the Brazilian Memory and Aging Study. Clin Neurol Neurosurg. 2024;243:108365.

    PubMed  Google Scholar 

  48. Baez S, Alladi S, Ibanez A. Global South research is critical for understanding brain health, ageing and dementia. Clin Transl Med. 2023;13:e1486.

    PubMed  PubMed Central  Google Scholar 

  49. Argentieri MA, Amin N, Nevado-Holgado AJ, Sproviero W, Collister JA, Keestra SM, et al. Integrating the environmental and genetic architectures of aging and mortality. Nat Med. 2025;31:1016–25.

    PubMed  PubMed Central  CAS  Google Scholar 

  50. Chong JR, Hilal S, Tan BY, Venketasubramanian N, Schöll M, Zetterberg H, et al. Clinical utility of plasma p-tau217 in identifying abnormal brain amyloid burden in an Asian cohort with high prevalence of concomitant cerebrovascular disease. Alzheimers Dement. 2025;21:e14502.

    PubMed  PubMed Central  CAS  Google Scholar 

  51. Groot C, Cicognola C, Bali D, Triana-Baltzer G, Dage JL, Pontecorvo MJ, et al. Diagnostic and prognostic performance to detect Alzheimer’s disease and clinical progression of a novel assay for plasma p-tau217. Alzheimers Res Ther. 2022;14:67.

    PubMed  PubMed Central  CAS  Google Scholar 

  52. Parra MA, Baez S, Allegri R, Nitrini R, Lopera F, Slachevsky A, et al. Dementia in Latin America: assessing the present and envisioning the future. Neurology. 2018;90:222–31.

    PubMed  PubMed Central  Google Scholar 

  53. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16:223–37.

    PubMed  PubMed Central  CAS  Google Scholar 

  54. Santamaria-Garcia H, Sainz-Ballesteros A, Hernandez H, Moguilner S, Maito M, Ochoa-Rosales C, et al. Factors associated with healthy aging in Latin American populations. Nat Med. 2023;29:2248–58.

    PubMed  PubMed Central  CAS  Google Scholar 

  55. Kaplan H, Thompson RC, Trumble BC, Wann LS, Allam AH, Beheim B, et al. Coronary atherosclerosis in indigenous South American Tsimane: a cross-sectional cohort study. Lancet. 2017;389:1730–9.

    PubMed  PubMed Central  Google Scholar 

  56. Borelli WV, Formoso CR, Bieger A, Ferreira PL, Zimmer ER, Pascoal TA, et al. Race-related population attributable fraction of preventable risk factors of dementia: a Latino population-based study. Alzheimers Dement. 2023;15:e12408.

    Google Scholar 

  57. Gatz M, Mack WJ, Chui HC, Law EM, Barisano G, Sutherland ML, et al. Prevalence of dementia and mild cognitive impairment in indigenous Bolivian forager-horticulturalists. Alzheimers Dement. 2023;19:44–55.

    PubMed  Google Scholar 

  58. Arrighi HM, Neumann PJ, Lieberburg IM, Townsend RJ. Lethality of Alzheimer disease and its impact on nursing home placement. Alzheimer Dis Assoc Disord. 2010;24:90–95.

    PubMed  Google Scholar 

  59. Bohnen NI, Djang DS, Herholz K, Anzai Y, Minoshima S. Effectiveness and safety of 18F-FDG PET in the evaluation of dementia: a review of the recent literature. J Nucl Med. 2012;53:59–71.

    PubMed  CAS  Google Scholar 

  60. Teunissen CE, Verberk IMW, Thijssen EH, Vermunt L, Hansson O, Zetterberg H, et al. Blood-based biomarkers for Alzheimer’s disease: towards clinical implementation. Lancet Neurol. 2022;21:66–77.

    PubMed  CAS  Google Scholar 

  61. Castro MC, Massuda A, Almeida G, Menezes-Filho NA, Andrade MV, de Souza Noronha KVM, et al. Brazil’s unified health system: the first 30 years and prospects for the future. Lancet. 2019;394:345–56.

    PubMed  Google Scholar 

  62. Ramanan VK, Graff-Radford J, Syrjanen J, Shir D, Algeciras-Schimnich A, Lucas J, et al. Association of plasma biomarkers of Alzheimer disease with cognition and medical comorbidities in a biracial cohort. Neurology. 2023;101:e1402–e1411.

    PubMed  PubMed Central  CAS  Google Scholar 

  63. Tsiknia AA, Edland SD, Sundermann EE, Reas ET, Brewer JB, Galasko D, et al. Sex differences in plasma p-tau181 associations with Alzheimer’s disease biomarkers, cognitive decline, and clinical progression. Mol Psychiatry. 2022;27:4314–22.

    PubMed  PubMed Central  CAS  Google Scholar 

  64. Schilling LP, Balthazar MLF, Radanovic M, Forlenza OV, Silagi ML, Smid J, et al. Diagnosis of Alzheimer’s disease: recommendations of the scientific department of cognitive neurology and aging of the Brazilian academy of neurology. Dement Neuropsychol. 2022;16:25–39.

    PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We acknowledge all participants that voluntarily provided time and effort for this study. This project was partly funded by FIPE/HCPA. WVB receives financial support by the Alzheimer’s Association (AACSFD-22-928689). PCLF is supported by the Alzheimer’s Association (AARFD-22-923814). BB is supported by the Alzheimer’s Association (grant No. AARFD-22-974627) and the National Institute of Aging (5 P01 AG025204-17). CSA is supported by the Global Brain Health Institute, Alzheimer’s Association, and Alzheimer’s Society (grant No. GBHI ALZ UK-23-971089), and Alzheimer’s Association (grant No. 24AACSF-1200375). DG is supported by the Alzheimer’s Association (AARFD-22-928702). GP is supported by the Alzheimer’s Association (24AARFD-1243899). PRN is supported by the Fonds de Recherche du Québec – Santé (FRQS; Chercheur Boursier, 2020-VICO-279314) and Colin J. Adair Charitable Foundation. TAP is supported by the NIA (5R01AG075336, 5R01AG073267). ERZ receives financial support from CNPq [312410/2018-2; 435642/2018- 9; 312306/2021-0; 409066/2022-2; 447074/2023-7; 409595/2023-3; and 444880/2024-0], ARD/FAPERGS [21/2551-0000673-0], Alzheimer’s Association [AARGD-21- 850670], CNPQ/FAPERGS/PRONEX [16/2551-0000475-7], Instituto Nacional de Ciência e Tecnologia em Excitotoxicidade Neuroproteção [465671/2014-4], Instituto Nacional de Ciência e Tecnologia em Saúde Cerebral (#406020/2022-1), Instituto Serrapilheira [Serra-1912-31365 and R-2401-47242], Alzheimer’s Association and National Academy of Neuropsychology [ALZ-NAN-22-928381], Secretary of Health of the State of Rio Grande do Sul (SES/RS 23/2000-0091938-0) and Ministry of Health (00030420240118-003490).

Author information

Author notes

  1. These authors contributed equally: Wyllians Vendramini Borelli, Pamela C. L. Ferreira, Wagner S. Brum.

  2. These authors jointly supervised this work: Raphael Machado Castilhos, Tharick A. Pascoal, Eduardo R. Zimmer.

Authors and Affiliations

  1. Department of Morphological Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil

    Wyllians Vendramini Borelli

  2. Memory Center, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil

    Wyllians Vendramini Borelli & Eduardo R. Zimmer

  3. Graduate Program in Biological Sciences: Pharmacology and Therapeutics (PPGFT), UFRGS, Porto Alegre, RS, Brazil

    Wyllians Vendramini Borelli, Artur Francisco Schumacher Schuh & Eduardo R. Zimmer

  4. Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Pamela C. L. Ferreira, João Pedro Ferrari-Souza, Andreia Rocha, Cristiano Schaffer Aguzzoli, Francieli Rohden, Guilherme Povala, Bruna Bellaver & Tharick A. Pascoal

  5. Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden

    Wagner S. Brum

  6. Graduate Program in Biological Sciences: Biochemistry (PPGBioq), UFRGS, Porto Alegre, RS, Brazil

    Wagner S. Brum, João Pedro Ferrari-Souza, Giovanna Carello-Collar, Francieli Rohden, Débora G. Souza, Bruna Bellaver & Eduardo R. Zimmer

  7. Cognitive and Behavioral Neurology Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil

    Maila Holz, Victoria Tizeli, Matheus Zschornack Strelow, Carolina Formoso, Marcia Lorena Fagundes Chaves & Raphael Machado Castilhos

  8. Global Brain Health Institute, University of California San Francisco (UCSF), San Francisco, USA

    Cristiano Schaffer Aguzzoli

  9. Brain Institute of Rio Grande do Sul, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil

    Cristiano Schaffer Aguzzoli & Eduardo R. Zimmer

  10. Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil

    Artur Francisco Schumacher Schuh

  11. Department of Pharmacology, UFRGS, Porto Alegre, RS, Brazil

    Artur Francisco Schumacher Schuh & Eduardo R. Zimmer

  12. Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal, Verdun, QC, Canada

    Pedro Rosa-Neto

  13. Department of Neurology and Neurosurgery, Psychiatry, and Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada

    Pedro Rosa-Neto

  14. The Peter OʼDonnell Jr Brain Institute, University of Texas Southwestern Medical Centre, Dallas, TX, USA

    Pedro Rosa-Neto

  15. Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Tharick A. Pascoal

  16. The McGill University Research Centre for Studies in Aging, McGill University, Montreal, QC, Canada

    Eduardo R. Zimmer

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  1. Wyllians Vendramini Borelli
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  2. Pamela C. L. Ferreira
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  3. Wagner S. Brum
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  4. João Pedro Ferrari-Souza
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  18. Pedro Rosa-Neto
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  19. Raphael Machado Castilhos
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  20. Tharick A. Pascoal
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  21. Eduardo R. Zimmer
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Correspondence to Eduardo R. Zimmer.

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Competing interests

WVB has served in the scientific advisory board of masima, and he is also a co-founder and a minority shareholder at masima. ERZ has served on the scientific advisory board, as a consultant or speaker for Nintx, Novo Nordisk, Biogen, Lilly, Magdalena Biosciences and masima. He is also a co-founder and a minority shareholder at masima.

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Borelli, W.V., Ferreira, P.C.L., Brum, W.S. et al. Diagnostic performance of Alzheimer’s disease blood and CSF biomarkers in a Brazilian cohort with low educational attainment. Mol Psychiatry 30, 6090–6098 (2025). https://doi.org/10.1038/s41380-025-03192-w

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  • DOI: https://doi.org/10.1038/s41380-025-03192-w

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