Beyond amyloid and tau: synaptic and neurodegenerative biomarkers shape MCI progression

Accurate prediction of which patients with mild cognitive impairment (MCI) will progress to dementia remains a major challenge. Current biomarkers detect amyloid pathology with high accuracy but offer limited prognostic value for disease progression. We conducted a prospective analysis in the multicentre BALTAZAR cohort, all diagnosed with MCI at baseline and followed for 3 years. Paired cerebrospinal fluid (CSF) and plasma samples were analysed with the NULISA ultrasensitive multiplex platform quantifying more than 120 central nervous system biomarkers. Prognostic performance was assessed using area under the curve (AUC) and hazard ratios (HRs), both for individual markers and for elastic-n