In recent years, there have been several core developments within the Alzheimer’s space – including the debut of the first disease-modifying therapies (DMTs), as well as the US regulatory clearance of the first blood-based Alzheimer’s diagnostic test.
Now, as the field progresses, experts at the 2026 Alzheimer’s Association International Conference (AAIC), which is being held from 12-15 July in London, were keen to discuss the burgeoning role of biomarkers in the Alzheimer’s research and diagnosis paradigms, as well as how they could bridge the gap between specialist and primary care.
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At the conference, researchers presented two studies looking at the real-world potential of biomarker testing in improving Alzheimer’s diagnosis, treatment and care.
Bringing accurate diagnosis into the everyday clinical care setting
With the World Health Organization (WHO) estimating that nearly 10 million cases of Alzheimer’s occur each year and around 57 million live with dementia worldwide, there is a clear need for early diagnosis, as well as effective treatments and care for the condition.
One way this could be achieved is by incorporating Alzheimer’s blood tests in the everyday clinical care setting, suggests new data presented at AAIC 2026.
According to findings from a real-world study incorporating more than 165 physicians and 1,300 patients, C2N Diagnostics’ blood-based biomarker test, PrecivityAD2, which measures for phosphorylated tau and amyloid beta, two abnormal proteins linked to Alzheimer’s, can significantly improve the accuracy of Alzheimer’s diagnosis in both the primary and speciality care settings.
This is evidenced by the near-identical diagnostic accuracy of when diagnoses were compared head-to-head between primary care physicians and specialists who received PrecivityAD2 test results, with the success rate sitting at 93% and 94% among the two groups, respectively.
Researchers also observed that the blood test results prompted primary care clinicians to alter their diagnoses in 30% of patients – with the most notable impact seen in ruling out Alzheimer’s disease, while dementia experts amended their diagnosis in 21.6% of patients and were more likely to make an immediate diagnosis without additional testing when the result came back positive.
While the blood test proved a useful tool for clinicians in the primary care setting, lead study author and neurologist Sebastian Palmqvist noted that this tool will likely hold the most significance in ruling out Alzheimer’s, rather than diagnosing the disease.
In conversation with Clinical Trials Arena, Christopher Weber, director of global science initiatives at the Alzheimer’s Association notes the findings of this study would be a key step forward for the Alzheimer’s space, as it highlights how blood-based biomarkers can help doctors make decisions about how they should move patients through the care pathway, while “closing the gap between primary care and specialists to reduce wait times”.
The role of biomarker testing in symptom-free individuals
Alongside the potential of blood-based biomarker tests in diagnosing patients in the primary care setting, these tools could also play a key role in identifying patients at risk of developing Alzheimer’s years before they begin to display symptoms, another study has found.
According to new research presented at AAIC 2026, adults with very high levels of the Alzheimer’s biomarker, p-tau217, were around 78% more likely to progress to cognitive impairment within a decade, while the risk of developing such symptoms in five years grew 38% in this group.
Although this risk appears to decrease relative to the degree of p-tau217 expression, individuals with moderate levels of the biomarker are still significantly impacted, and are 15% and 45% more likely to develop cognitive impairment at the five and 10-year timeframes, respectively.
According to Reisa Sperling, senior author and a neurologist at the Mass General Brigham Neuroscience Institute, the information accrued in this study will likely become more relevant if current trials can provide clear evidence that cognitive decline can be prevented by beginning treatment before symptoms begin.
However, these results hold the potential to help researchers now, Weber says, as such tests could be used to identify cognitively healthy adults at risk of Alzheimer’s who would be eligible to take part in prevention studies – potentially ushering in the next generation of therapies for the disease. The cost-effectiveness of blood-based biomarker testing could also help to reduce the ever-present screening bottleneck faced by large-scale prevention trial sponsors, Weber adds.
Despite this, researchers don’t believe that p-tau217 alone can provide the full picture of an individual’s risk, as factors including genetics, age, obesity, kidney function and ethnic background can all play a role in influencing both biomarkers and the risk of dementia.
According to a 2025 report from the Alzheimer’s Association, nearly four in five Americans would want to know if they have Alzheimer’s before symptoms start, and 90% would take a blood test if it were available to them, as the public increasingly wants to understand their future risk instead of obtaining a diagnosis after symptoms start.
Fortifying the Alzheimer’s diagnostic framework
As the Alzheimer’s field progresses, Weber notes that it should aim for the availability of routine, early screening for both at-risk individuals and those with the disease – with non-invasive methods like digital biomarkers leading into additional testing like blood-based biomarkers, which then segway into cerebrospinal fluid (CSF) and PET scans to better streamline the pathway.
Such models have similarly been replicated in the oncology and cardiovascular disease spaces, Weber adds, and the ability to harness such an approach would help inform what the patient care pathway should look like based on symptoms and risk factors.
Biomarkers can also allow drugmakers to look earlier into disease pathology and create “more shots on goal” for early-stage therapeutics, Weber comments, which could translate directly into better treatment outcomes for patients in the future.
While Weber touts the strong role of biomarkers, he stresses that they are not yet able to replace clinical judgement. “We could refer to them as decision support tools; they’re a piece of the puzzle within a full clinician workup, and they aren’t yet ready to be considered standalone diagnostics,” Weber says.
As biomarkers come to the forefront, researchers unpick the complexities of Alzheimer’s pathology and drugmakers develop new solutions for patients, Weber believes that a combination of drugs and lifestyle interventions, as well as the rise of fluid and digital-based biomarkers, will move the field forward in the years to come.
