eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2025-12-30 18 4 2618 2634 10.13005/bpj/3281 69024 article Pydikondala Nehitha Purna 1 Pydiraju Kondrapu 2 Alekhya Ketha 3 Shashikala Metri 4 Nagaraju Bandaru 5 Department of Pharmaceutical Sciences, Koringa College of Pharmacy, Korangi, India Department of Pharmacology, Adarsa College of Pharmacy, G. Kothapalli-533285, Andhra Pradesh Department of Pharmaceutical Chemistry, Sree Dattha Institute of Pharmacy, Sheriguda, Ibrahimpatnam, Hyderabad, India. Department of Pharmacognosy, Gokaraju Rangaraju College of Pharmacy, Hyderabad, Telangana, India. Department of Pharmacology, School of Pharmaceutical Sciences, Sandip University, Nashik, Maharashtra, India. Alzheimer’s disease (AD) is the most prevalent neurodegenerative disorder characterized by progressive cognitive decline and memory impairment. Early and accurate diagnosis remains a pivotal challenge to improve patient outcomes and guide therapeutic interventions. In recent years, cerebrospinal fluid (CSF) and blood biomarkers have emerged as critical tools for the detection and monitoring of AD pathology. CSF biomarkers such as amyloid-beta 42 (Aβ42), total tau (t-tau), and phosphorylated tau (p-tau) directly reflect hallmark pathological changes, including amyloid plaque accumulation and neurofibrillary tangles, offering high diagnostic specificity. However, lumbar puncture’s invasiveness limits routine use, prompting the development of blood-based biomarkers. Advances in ultrasensitive assay technologies have enabled reliable quantification of plasma Aβ42/40 ratios, phosphorylated tau isoforms (p-tau181, p-tau217), and neurofilament light chain (NfL), correlating strongly with AD pathology and clinical progression. Blood biomarkers provide a minimally invasive, accessible approach suitable for large-scale screening, early detection, and longitudinal monitoring. Integrating CSF and blood biomarkers with neuroimaging and cognitive assessments enhances diagnostic precision and supports personalized treatment strategies. Nonetheless, several challenges remain, including inter-assay variability, population heterogeneity, and standardization across laboratories, and limited validation in diverse clinical settings. Addressing these limitations is essential for translating biomarker discoveries into routine clinical practice. This review synthesizes current knowledge on CSF and blood biomarker advancements, evaluates their clinical applications, and discusses emerging challenges and future perspectives in biomarker-driven diagnosis and management of Alzheimer’s disease. https://biomedpharmajournal.org/vol18no4/review-on-role-of-cerebrospinal-fluid-and-blood-biomarkers-in-alzheimers-disease-diagnosis/ Alzheimer’s disease Amyloid-beta Blood biomarkers CSF biomarkers Tau protein