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In accordance with the current German dementia guidelines, the dementia biomarkers amyloid beta 42, the tau peptides total tau and phosphorylated tau 181 are recommended for cerebrospinal fluid (CSF)-based diagnostics of dementia. Several studies have clearly shown that determination of the amyloid beta 42 to amyloid beta 40 peptide ratio is superior to the interpretation of amyloid beta 42 alone and should be implemented in the clinical work-up; however, in recent years different studies have presented many other innovative CSF and blood-based biomarkers. Besides CSF-based neurochemical diagnostics of dementia promising novel protocols for the detection of amyloid beta peptides in blood have meanwhile been published, which can currently be used in clinical studies for blood-based early diagnostics of Alzheimer's dementia. Following further validation and assay optimization these blood assays should be available for routine diagnostics in the near future. [ABSTRACT FROM AUTHOR]

Over the past 10 years, the status of laboratory analysis in dementia has increasingly changed from its use for exclusion diagnoses for secondary causes of dementias to determining positive diagnoses of neurodegenerative dementias. This especially applies to the cerebrospinal fluid diagnosis of Alzheimer's disease (AD). Just a few years ago, a lumbar puncture was advised only with sufficiently founded clinical suspicion and with higher priority for the exclusion of inflammatory causes of cognitive dementias. In contrast, pathologically changed biomarkers in the cerebrospinal fluid have already been indexed as supportive attributes of the diagnosis in the 2007 amended research criteria of AD. The lumbar puncture is therefore increasingly becoming part of the clinical routine diagnosis of demential processes and has, to some extent, far-reaching consequences. In this article, we discuss some of the important aspects. [ABSTRACT FROM AUTHOR]