Blood Biomarkers of Alzheimer Disease and Rates of Global and Domain-Specific Cognitive Decline

Abstract

Key Points Question What is the association of different blood-based biomarkers of Alzheimer disease (AD) with global and domain-specific cognitive decline in the general population? Findings In this cohort study of 2008 older adult participants in the Swedish National Study on Aging and Care–Kungsholmen, AD-related biomarkers, especially phosphorylated tau 217, phosphorylated tau 181, neurofilament light chain, and glial fibrillary acidic protein, were associated with faster rates of cognitive decline over up to 15 years of follow-up. Associations differed depending on the biomarker measured and participant sex and APOE genotype. Meaning Easily accessible blood-based biomarkers of AD may be linked to subsequent faster cognitive decline in the general older population, with patterns suggesting some heterogeneity across biomarkers and that individual characteristics may influence clinical interpretation.