Alzheimer Disease Blood Biomarkers and Cognition Among Individuals With Diabetes and Overweight or Obesity
Authors' conclusion
In this study of participants with T2D and overweight or obesity, increasing plasma NfL and GFAP levels over time, but not Aβ42/40 or pTau-181 levels, were associated with cognitive decline and incident cognitive impairment. These results suggest that plasma NfL and GFAP may be important biomarkers of cognitive change among this patient population.
Study context
- Population
- Older adults with T2D and overweight or obesity in Look AHEAD, 16 US clinical sites; mean (SD) baseline age 61.5 (6.1) years, 55.9% female, mean (SD) BMI 34.8 (5.3)
- Participants
- 758 adults
- Exposure
- Baseline and 8- to 12-year change in plasma Alzheimer disease (AD)/AD-related dementias (ADRD) BBMs vs cognition
- Diabetes support and educationn = 373reference
- Intensive lifestyle interventionn = 385
- Outcome
- Cognitive composite z score and adjudicated mild cognitive impairment or probable dementia
Methodological detailssecondary analysis of the Look AHEAD randomised trial, longitudinal, multicentre (16 US clinical sites), Enrollment 2001–2004; trial stopped September 2012 and converted to an observational study, Blood samples at baseline and 8 to 12 years later; cognitive assessments 2013–2014 and 2018–2020
- Secondary analysis of the Look AHEAD randomised trial
- Longitudinal
- Multicentre (16 US clinical sites)
- Enrollment 2001–2004; trial stopped September 2012 and converted to an observational study
- Blood samples at baseline and 8 to 12 years later; cognitive assessments 2013–2014 and 2018–2020
Main finding
As reported in the abstract
Increasing NfL
β = −0.032
SE, 0.013P = .01
Increasing glial fibrillary acidic protein (GFAP)
β = −0.087
SE, 0.025P < .001
Increasing Aβ42/40 ratio (not associated)
β = 0.006
SE, 0.040P = .88
Increasing pTau-181 (not associated)
β = 0.026
SE, 0.025P = .31
Observational data: associations, not effects.
Further findings
Baseline BBM levels and cognitive composite z score
- Increasing baseline BBM levels were not associated with any cognitive composite z score
Intervention and 8- to 12-year change in BBM levels
- The intervention had no association with change in BBM levels
Original publication
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