Amyloid beta and alpha 1-antichymotrypsin (ACT) play an important role in the pathogenesis of sporadic Alzheimer's disease (AD). The present study was to investigate whether a combination of plasma biomarkers and clinical data would discriminate AD from vascular dementia, other neurodegenerative dementia and non-demented controls. The study included 112 patients with AD, 85 patients with vascular dementia, 30 patients with other neurodegenerative dementia and 116 age-matched, non-demented controls. Although ACT, A beta 42 and the ratio of Ar beta 42/A beta 40 had significant differences between AD, vascular dementia, other neurodegenerative dementia and non-demented controls (P < 0.001), none of them reached the sensitivity and specificity required for AD biomarkers. The combination of biomarkers and clinical data had higher discriminating power than either alone. Our results indicated that plasma biomarkers of ACT and the ratio of A beta 42/A beta 40 could discriminate AD from non-demented controls, vascular dementia, or other neurodegenerative dementias with higher diagnostic accuracy than clinical data and that if plasma biomarkers were combined with clinical data, the discriminating power was enhanced. (c) 2012 Elsevier Ireland Ltd. All rights reserved.