Tau Protein and Beta Amyloid

Also Known As:
Alzheimer Biomarkers

Formal Name:
Tau Protein and Amyloid Beta 42 Peptide

This article was on. September 22, 2020

Learn more about...

Medical Laboratory Professionals: Who's Who in the Lab

At a Glance

Why Get Tested?

To help distinguish between Alzheimer disease and other forms of dementia

When To Get Tested?

These tests may be ordered along with cognitive and brain-imaging tests in people who demonstrate some form of dementia. These tests are not routine laboratory tests and are typically available only in research settings or memory clinics.

Sample Required?

A sample of cerebrospinal fluid collected using a lumbar puncture (spinal tap)

Test Preparation Needed?

Your healthcare practitioner will advise you on how you need to prepare for the test.

Looking For Test Results?

Looking For Reference Ranges?

You may be able to find your test results on your laboratory’s website or patient portal. However, you are currently at Lab Tests Online. You may have been directed here by your lab’s website in order to provide you with background information about the test(s) you had performed. You will need to return to your lab’s website or portal, or contact your healthcare practitioner in order to obtain your test results.

Lab Tests Online is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.

The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.

If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.

Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called “normal” values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.

While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are “within normal limits.”

For more information, please read the article Reference Ranges and What They Mean.

What is being tested?

Two separate laboratory tests can measure amyloid beta 42 (beta amyloid) and tau protein in cerebrospinal fluid (CSF). These tests are often done at the same time to help evaluate an individual for Alzheimer disease (AD).

Amyloid beta 42 is a peptide (protein fragment). Increased production of amyloid beta 42 in the brain can lead to the formation of amyloid plaques.
Tau is a structural protein in the brain. Tau protein containing many phosphorus groups (P-tau) can produce neurofibrillary tangles, which are twisted protein fragments that develop in nerve cells and disrupt the cells’ ability to transport signals.

Neurofibrillary tangles and amyloid plaques are considered to be the main diagnostic features of Alzheimer disease.

The measurements of tau and beta amyloid in CSF are being evaluated for potential roles in the diagnosis and monitoring of AD. It has been shown that a decrease in beta amyloid with elevated tau or P-tau levels may predict the onset of AD.

Common Questions

How is the test used?

Lab tests for tau protein and beta amyloid may be used as supplemental tests to help evaluate a person suspected of having Alzheimer disease (AD) and to distinguish between AD and other forms of dementia. These tests are not widely used or routinely ordered. Use of these tests is limited to people suspected of having dementia, and testing is typically performed after other causes of a person’s symptoms have been ruled out.

When is it ordered?

Tau protein and beta amyloid tests are primarily performed in research settings and in some memory clinics. The tests may be done along with cognitive tests and brain scans when an individual has signs and symptoms of Alzheimer disease, such as:

Loss of memory that affects daily life—forgetting information that was recently learned. This can occur with normal aging, but the information is usually remembered later. This includes forgetting important dates or events, having to rely on memory aids, and asking for the same information again and again.
Difficulty planning or problem solving, such as keeping track of bills and payments
Problems completing usual tasks, such as forgetting how to get to a familiar location
Confusion about place or time—losing track of time, forgetting where you are or how you got there
Increasing difficulty reading or judging distances
Problems speaking or writing—forgetting words, repeating the same thing, struggling with vocabulary
Losing things more frequently and not being able to logically retrace steps to find them
Impaired judgment, such as giving away unusually large amounts of money
Increasing withdrawal from activities, including social, work or family events
Changes in mood and personality, such as increasing anxiety, fear, suspicion and depression

Some healthcare practitioners may order these tests for other reasons; however, information on how to interpret the results outside of the settings described above is limited.

What does the test result mean?

In a person with symptoms, a low beta amyloid CSF level along with a high tau protein level reflects an increased likelihood of Alzheimer disease. However, these abnormal results can also occur in other conditions.

Is there anything else I should know?

The clinical use of these tests continues to evolve. For instance, multiple variants of amyloid beta protein, such as amyloid beta 40 and amyloid beta 38, have been identified and are being researched for their potential use as AD biomarkers. Other CSF and blood tests for AD are also being researched.

What tests are usually done to evaluate a person for Alzheimer disease?

If someone has symptoms of dementia, a healthcare practitioner will do a thorough work-up to try to determine the cause. This work-up may include a variety of cognitive tests (such as a Minimal Mental State Exam) to assess memory and possibly PET scanning tests of the brain to look for abnormalities. Read the article on Alzheimer Disease for additional details.

How is Alzheimer disease definitively diagnosed?

Alzheimer disease is currently diagnosed based on cognitive changes and by ruling out other causes of these changes. The diagnosis is definitively confirmed after death by looking for microscopic changes in a person’s brain tissue. The microscopic evaluation involves looking for the number of amyloid plaques and neurofibrillary tangles found in the brain. Characteristic changes on brain scans (MRI or PET scans) and/or low beta amyloid and high tau protein levels in CSF (where available) may be ordered to help establish a diagnosis.

Can I have my blood tested for beta amyloid and tau instead of my CSF?

Not at this time. Studies of blood measurements of beta amyloid and tau have not shown them to be useful in determining what is occurring in a person’s brain.

View Sources

Sources Used in Current Review

Simonsen, A. et. al. (2017 March). Recommendations for CSF AD biomarkers in the diagnostic evaluation of dementia. Alzheimers Dement. 2017 Mar;13(3):274-28. Available online at https://www.ncbi.nlm.nih.gov/pubmed/28341065. Accessed February 2019.

Niemantsverdriet, E. et. al. (2017 July 27). Alzheimer’s disease CSF biomarkers: clinical indications and rational use. Acta Neurol Belg. 2017; 117(3): 591–602. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565643/. Accessed February 2019.

Martins, R. (2018 March 13). Alzheimer’s Disease: A Journey from Amyloid Peptides and Oxidative Stress, to Biomarker Technologies and Disease Prevention Strategies-Gains from AIBL and DIAN Cohort Studies. J Alzheimers Dis. 2018;62(3):965-992. Available online at https://www.ncbi.nlm.nih.gov/pubmed/29562546. Accessed February 2019.

Lautner, R. et. al. (2017 October 23). Preclinical effects of APOE ε4 on cerebrospinal fluid Aβ42 concentrations. Alzheimers Res Ther. 2017 Oct 23;9(1):87. Available online at https://www.ncbi.nlm.nih.gov/pubmed/29061195. Accessed February 2019.

Li, G. et. al. (2017 July 3). Cerebrospinal fluid biomarkers for Alzheimer’s and vascular disease vary by age, gender, and APOE genotype in cognitively normal adults. Alzheimers Res Ther. 2017 Jul 3;9(1):48. Available online at https://www.ncbi.nlm.nih.gov/pubmed/28673336. Accessed February 2019.

Blennow, K. (2017 July 6). A Review of Fluid Biomarkers for Alzheimer’s Disease: Moving from CSF to Blood. Neurol Ther. 2017 Jul;6(Suppl 1):15-24. Available online at https://www.ncbi.nlm.nih.gov/pubmed/28733960. Accessed February 2019.

Jan, A. et. al. (2017 November 1). Perspective Insights into Disease Progression, Diagnostics, and Therapeutic Approaches in Alzheimer’s Disease: A Judicious Update. Front Aging Neurosci. 2017 Nov 1;9:356. Available online at https://www.ncbi.nlm.nih.gov/pubmed/29163138. Accessed February 2019.

Niemantsverdriet, E. et. al. (2018 April 10). Added Diagnostic Value of Cerebrospinal Fluid Biomarkers for Differential Dementia Diagnosis in an Autopsy-Confirmed Cohort. J Alzheimers Dis. 2018; 63(1): 373–381. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5900550/. Accessed February 2019.

Sources Used in Previous Reviews

Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby’s Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

Sloane, P. (1998, November 1). Advances in the Treatment of Alzheimer’s Disease. American Family Physician by the American Academy of Family Physicians [On-line journal]. Available online at http://www.aafp.org/afp/981101ap/sloane.html.

Eastman, P. (2002 March). Keeping Alzheimer’s at Bay, Early Diagnosis Keeps Patients Functioning Longer. AARP Bulletin Online [On-line serial]. Available online at http://www.aarp.org/bulletin/departments/2002/health/0310_health_1.html.

McConnell, S. , et. al. Unraveling the Mysteries of Alzheimer’s Disease: Exciting New Developments in Research. From panel sponsored by the Alzheimer’s Association [On-line information]. Available online at http://www.asaging.org/am/cia2/alzheimer.html.

Galasko, D., et. al. (1998). High Cerebrospinal Fluid Tau and Low Amyloid b42 Levels in the Clinical Diagnosis of Alzheimer Disease and Relation to Apolipoprotein E Genotype. Arch Neurol [On-line journal], vol (55) pages (937-945). Available online at http://archneur.ama-assn.org/issues/v55n7/abs/noc7433.html.

ARF (1996-2002). Standard Medical Workup for Alzheimer’s Disease. Alzheimer Research Forum [On-line information]. Available online at http://www.alzforum.org/members/research/treatment_guide/workup.html.

Family Caregiver Alliance. Fact Sheet: Alzheimer’s Disease [On-line information]. Available online at http://www.caregiver.org/factsheets/diagnoses/alzheimersC.html.

Bird, T. (2001 June 22 last update). Alzheimer Overview. GeneReviews [On-line information]. Available online through http://www.genetests.org.

Gottlieb, F. and Lambert, J. G. (2002, January 2, last update). Alzheimer’s Disease. MedlinePlus [On-line information]. Available online at http://www.nia.nih.gov.

NIH (2000). Progress report on Alzheimer’s disease, taking the next steps. NIH Publication No. 00-4859 [On-line report]. Available online at http://www.alzheimers.org/pubs/prog00.htm#Introduction.

UniSci (2002, April 08). New Approaches Seen For Early Alzheimer’s Diagnosis. Daily University Science News [On-line Article]. Available online at http://unisci.com/stories/20022/0408025.htm.

Eldercare (2002 February 28, last update). Is it Alzheimer’s … or Just Forgetfulness? Sponsored by Nebraska’s Area Agencies on Aging [On-line information]. Available online at http://nncf.unl.edu/eldercare/info/lifeline/LLforget.html.

Diagnostic Education, Neurological Disorders, Alzheimer’s Disease. Athena Diagnostics [On-line information]. Available online at http://www.athenadiagnostics.com/site/content/neuro_alzheim_dis.asp.

NeuroCast. Neuropathology of Alzheimer’s Disease. Athena Diagnostics [On-line information]. Available online at http://www.neurocast.com/site/content/sessions_Neuro_Alzheimer’s.shtml.

NeuroCast. Biochemistry of Alzheimer’s Disease. Athena Diagnostics [On-line information]. Available online at http://www.neurocast.com/site/content/sessions_Biochemistry_Alzheimer’s.shtml.

Hain, T. (2000 February 13). Alzheimer’s Disease. Neurology, Northwestern University Medical School. Available online at http://www.neuro.nwu.edu/meded/behavioral/alzheimers.html.

Kleiner-Fisman, G., Updated by (2002 January 2, last update). CSF Collection. MedlinePlus [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003428.htm.

Lawrence Mayer, MD, PhD. Professor, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD.

American Academy of Neurology guidelines on dementia: PDF available for download at http://www.aan.com/professionals/practice/pdfs/dementia_guideline.pdf.

Sunderland, T et al. Decreased beta-amyloid1-42 and increased tau levels in cerebrospinal fluid of patients with Alzheimer disease. JAMA. 2003 Apr 23-30;289(16):2094-103. Available online at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=pubmed.

Andreasen, Niels. Biochemical markers and diagnosis of Alzheimer’s Disease. Alzheimer Insights Online, Vol. 7, No. 3. Available online at http://www.alzheimer-insights.com/insights/vol7no3/vol7no3b.htm.

Alzheimer’s Research at Mayo Clinic. 11/11/2003. Available online at http://mayoresearch.mayo.edu/mayo/research/Featured_Stories/alzheimers_disease/.

(Updated 2008 December 15) Alzheimer’s Disease. CDC Features [On-line information]. Available online at http://www.cdc.gov/Features/Alzheimers/. Accessed February 2009.

(Updated 2009 February 5) Understanding Stages and Symptoms of Alzheimer’s Disease. National Institute on Aging [On-line information]. Available online at http://www.nia.nih.gov/NR/exeres/6739F4B3-C1A9-4564-8AC3-77DC1315974E.htm. Accessed February 2009.

Welsh-Bohmer, K. and White, C. (Current 2009 February 17) Alzheimer disease: What changes in the brain cause dementia? American Academy of Neurology 2009;72:e21 [On-line information]. Available online through http://www.neurology.org. Accessed February 2009.

Rodgers, A. (Updated 2008 November 28) Alzheimer’s Disease: Unraveling the Mystery. National Institute on Aging, ADEAR [On-line information]. Available online at http://www.nia.nih.gov/Alzheimers/Publications/Unraveling/. Accessed February 2009.

Portelius, E. et. al. (2008 June 20) Targeted Proteomics in Alzheimer’s Disease: Focus on Amyloid-Beta. Medscape.com from Expert Rev Proteomics 2008;5(2):225-237 [On-line information]. Available online at http://www.medscape.com/viewarticle/575519. Accessed February 2009.

Yaari, R. and Corey-Bloom, J. (2007 March 07). Alzheimer’s Disease. Medscape.com from Seminars in Neurology Semin Neurol 2007;27(1):32-41 [On-line information]. Available online at http://www.medscape.com/viewarticle/553256. Accessed February 2009.

Harrison’s Principles of Internal Medicine. 16th ed. Kasper D, Braunwald E, Fauci A, Hauser S, Longo D, Jameson JL, eds. McGraw-Hill, 2005, P. 2399.

Tapiola T, Alafuzoff I, Sanna-Kaisa, et. al. Cerebrospinal fluid B-amyloid 42 and tau proteins as biomarkers of Alzheimer-type pathologic changes in the brain. Arch Neurol 66(3):382-389, 2009.

Snider BJ, Fagan AM, Roe, C, et. al. Cerebrospinal fluid biomarkers and rate of cognitive decline in very mild dementia of Alzheimer type. Arch Neurol 66(5):638-645, 2009.

Anderson, H. (Updated 2014 March 3). Alzheimer Disease. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/1134817-overview. Accessed March 2014.

Brooks, M. (2012 April 25). Both Hallmark AD Proteins Needed for Cognitive Decline. Medscape Today News [On-line information]. Available online at http://www.medscape.com/viewarticle/762641. Accessed March 2014.

Braak, H. and Tredici, K. (2012). Where, When, and in What Form Does Sporadic Alzheimer’s Disease Begin? Curr Opin Neurol. 2012;25(6):708-714. Available online at http://www.medscape.com/viewarticle/777763. Accessed March 2014.

Schott, J. and Warren, J. (2012). Alzheimer’s Disease, Mimics and Chameleons. Pract Neurol. 2012;12(6):358-366. [On-line information]. Available online at http://www.medscape.com/viewarticle/774935. Accessed March 2014.

Lowry, F. (2012 January 10). CSF Abnormalities Early Harbinger of Alzheimer’s. Medscape Today News [On-line information]. Available online at http://www.medscape.com/viewarticle/756633. Accessed March 2014.

Barclay, L. (2009 April 7). Biomarkers for Alzheimer’s Disease. Medscape Today News [On-line information]. Available online at http://www.medscape.com/viewarticle/590266. Accessed March 2014.

Stetka, B. (2013 April 1). Alzheimer Biomarkers in Clinical Practice. Medscape Today News [On-line information]. Available online at http://www.medscape.com/viewarticle/781533. Accessed March 2014.

Ask a Laboratory Scientist

This form enables patients to ask specific questions about lab tests. Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, American Society for Clinical Laboratory Science. Please allow 2-3 business days for an email response from one of the volunteers on the Consumer Information Response Team.