Also Known As
Alzheimer Biomarkers
Formal Name
Tau Protein and Amyloid Beta 42 Peptide
This article was last reviewed on
This article waslast modified on September 12, 2018.
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 spinal tap

Test Preparation Needed?

Your healthcare practitioner will advise you of any preparatory requirements.

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?

These tests measure amyloid beta 42 (Aß42) and tau protein in cerebrospinal fluid (CSF). Amyloid beta 42 is a peptide (protein fragment). Increased production of amyloid beta 42 in the brain can lead to the formation of senile plaques. Tau is a structural protein in the brain. When tau becomes saturated with phosphorus groups (P-tau), it can produce neurofibrillary tangles, twisted protein fragments that develop in neurons (nerve cells) and disrupt their ability to transport signals. Neurofibrillary tangles and senile plaques are considered to be the main diagnostic features of Alzheimer disease (AD) that are seen at autopsy.

The measurement of tau and Aß42 in CSF is being evaluated for potential roles in the diagnosis and monitoring of AD. It has been shown that a decrease in Aß42 with elevated tau or P-tau levels may predict the onset of AD.

Accordion Title
Common Questions
  • How is it used?

    Tests for Tau protein and Aß42 may be used as supplemental tests to help establish a diagnosis of Alzheimer disease and to distinguish between AD and other forms of dementia. These tests are not widely used or routinely ordered. Use is limited to those suspected of 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 Aß42 tests are primarily performed in research settings and in some memory clinics in conjunction with cognitive tests and brain scans when someone has symptoms of dementia, such as memory loss, behavioral changes, and decreased ability to perform daily life functions. Some health practitioners may order them outside of these settings; however, information on how to interpret the results is limited.

  • What does the test result mean?

    In a symptomatic person, a low Aß42 CSF level along with a high tau level reflects an increased likelihood of Alzheimer disease. Recent studies have shown that these abnormal levels may predict a rapid progression of AD. Since these are still in a research phase and not part of routine examinations, it is unclear as to whether all who might have abnormal results would definitely have AD.

  • Is there anything else I should know?

    Assessments of Aß42 and tau protein levels do not singularly establish a diagnosis of Alzheimer disease; they represent a common finding that may be used in conjunction with other tests and the person's clinical and family history to suggest a diagnosis of AD.

    The clinical use of these tests continues to evolve. For instance, multiple variants of amyloid beta protein, such as Aß40 and Aß38, have been identified and are being researched for their potential use as AD biomarkers.

    If someone has symptoms of dementia, a health 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 (Pittsburgh Compound-B) of the brain to look for abnormalities.

  • How is Alzheimer disease definitively diagnosed?

    Alzheimer disease is currently diagnosed based on cognitive changes and by ruling out other causes of these changes. It 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 senile plaques and neurofibrillary tangles found in the brain. Characteristic changes on brain scans (MRI or PET scans) and/or low Aß42 and high tau protein levels in CSF (where available) may be ordered to help in the diagnosis.

  • Can I have my blood tested for Aβ42 and tau instead of my CSF?

    Not at this time. Studies of blood measurements of Aß42 and tau have not shown them to be useful reflections of what is occurring in a person's brain.

View Sources

Sources Used in Current Review

Anderson, H. (Updated 2014 March 3). Alzheimer Disease. Medscape Reference [On-line information]. Available online at through 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 through 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 through 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 through Accessed March 2014.

Lowry, F. (2012 January 10). CSF Abnormalities Early Harbinger of Alzheimer's. Medscape Today News [On-line information]. Available online at through Accessed March 2014.

Barclay, L. (2009 April 7). Biomarkers for Alzheimer's Disease. Medscape Today News [On-line information]. Available online at through Accessed March 2014.

Stetka, B. (2013 April 1). Alzheimer Biomarkers in Clinical Practice. Medscape Today News [On-line information]. Available online at through Accessed March 2014.

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 through

Eastman, P. (2002 March). Keeping Alzheimer's at Bay, Early Diagnosis Keeps Patients Functioning Longer. AARP Bulletin Online [On-line serial]. Available online at through

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 through

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 through

ARF (1996-2002). Standard Medical Workup for Alzheimer's Disease. Alzheimer Research Forum [On-line information]. Available online at through

Family Caregiver Alliance. Fact Sheet: Alzheimer's Disease [On-line information]. Available online at through

Bird, T. (2001 June 22 last update). Alzheimer Overview. GeneReviews [On-line information]. Available online through

Gottlieb, F. and Lambert, J. G. (2002, January 2, last update). Alzheimer's Disease. MEDLINEplus [On-line information]. Available online at

NIH (2000). Progress report on Alzheimer's disease, taking the next steps. NIH Publication No. 00-4859 [On-line report]. Available online at through

UniSci (2002, April 08). New Approaches Seen For Early Alzheimer's Diagnosis. Daily University Science News [On-line Article]. Available online at through

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 through

Diagnostic Education, Neurological Disorders, Alzheimer's Disease. Athena Diagnostics [On-line information]. Available online at through

NeuroCast. Neuropathology of Alzheimer's Disease. Athena Diagnostics [On-line information]. Available online at's.shtml through

NeuroCast. Biochemistry of Alzheimer's Disease. Athena Diagnostics [On-line information]. Available online at's.shtml through

Hain, T. (2000 February 13). Alzheimer's Disease. Neurology, Northwestern University Medical School. Available online at through

Kleiner-Fisman, G., Updated by (2002 January 2, last update). CSF Collection. MEDLINEplus [On-line information]. Available online at

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 through

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 through

Andreasen, Niels. Biochemical markers and diagnosis of Alzheimer's Disease. Alzheimer Insights Online, Vol. 7, No. 3. Available online at through

Alzheimer's Research at Mayo Clinic. 11/11/2003. Available online at through

(Updated 2008 December 15) Alzheimer's Disease. CDC Features [On-line information]. Available online at through 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 through 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 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 through Accessed February 2009.

Portelius, E. et. al. (2008 June 20) Targeted Proteomics in Alzheimer's Disease: Focus on Amyloid-Beta. from Expert Rev Proteomics 2008;5(2):225-237 [On-line information]. Available online at through Accessed February 2009.

Yaari, R. and Corey-Bloom, J. (2007 March 07). Alzheimer's Disease. from Seminars in Neurology Semin Neurol 2007;27(1):32-41 [On-line information]. Available online at through 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.

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