Wei Min, Yu Xianfeng, Hu Shimin, Hu Wenjing, Shi Rong, Wang Min, Zhong Jiayi, Zhang Qi, Zhang Ying, Li Chenyang, Song Ziyan, Jiang Jiehui, Han Ying
Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
Institute of Biomedical Engineering, School of Life Sciences, Shanghai University, Shanghai, China.
J Alzheimers Dis. 2025 Feb;103(4):1060-1074. doi: 10.1177/13872877241309105. Epub 2025 Jan 10.
Plasma biomarkers demonstrated potential in identifying amyloid pathology in early Alzheimer's disease. Different subtypes of subjective cognitive decline (SCD) may lead to different cognitive impairment conversion risks.
To investigate the differences of plasma biomarkers in SCD subtypes individuals, which were unclear.
The 347 individuals were involved, including 93 normal controls (NC), 76 single memory domain SCD (sd-SCD), 79 multidomain SCD (md-SCD), 55 mild cognitive impairment and 44 dementia. We investigated plasma biomarkers (Aβ, p-tau181, p-tau217, NfL, and GFAP) and neuropsychological scales in the baseline and follow-up. The Kaplan-Meier survival analysis and Cox proportional hazards model were performed to investigate the risk of cognitive decline conversion. The t-test, Mann-Whitney U and multiple linear regression analysis were employed to evaluate the rate of change and correlation between PET-SUVR and plasma biomarker change.
In cognitively normal subjects, md-SCD exhibited lower Aβ and higher p-tau181 and p-tau217 levels. Kaplan-Meier survival analysis revealed that md-SCD group exhibited a higher risk of cognitive decline conversion compared to NC and sd-SCD. Within SCD subgroups, those with positive GFAP status showed higher conversion risk than negative. In the Cox model, the risk of conversion in the md-SCD group was 2.77 times higher than sd-SCD. The md-SCD group demonstrated a faster rate of Aβ decline than sd-SCD.
The study utilized plasma biomarkers to highlight the significance of staging in SCD. In cognitively normal subjects, md-SCD presents a higher risk of cognitive decline than sd-SCD, providing a valuable reference and convenient tool for early identification of individuals at risk for AD.
血浆生物标志物在早期阿尔茨海默病淀粉样病理的识别中显示出潜力。主观认知下降（SCD）的不同亚型可能导致不同的认知障碍转化风险。
探讨SCD亚型个体血浆生物标志物的差异，此前尚不清楚。
纳入347名个体，包括93名正常对照（NC）、76名单一记忆域SCD（sd-SCD）、79名多域SCD（md-SCD）、55名轻度认知障碍和44名痴呆患者。我们在基线和随访时调查了血浆生物标志物（Aβ、p-tau181、p-tau217、NfL和GFAP）和神经心理量表。采用Kaplan-Meier生存分析和Cox比例风险模型来研究认知下降转化的风险。采用t检验、Mann-Whitney U检验和多元线性回归分析来评估PET-SUVR的变化率以及与血浆生物标志物变化之间的相关性。
在认知正常的受试者中，md-SCD的Aβ水平较低，p-tau181和p-tau217水平较高。Kaplan-Meier生存分析显示，与NC和sd-SCD相比，md-SCD组认知下降转化的风险更高。在SCD亚组中，GFAP状态为阳性的个体比阴性个体具有更高的转化风险。在Cox模型中，md-SCD组的转化风险比sd-SCD高2.77倍。md-SCD组的Aβ下降速度比sd-SCD组更快。
该研究利用血浆生物标志物突出了SCD分期的重要性。在认知正常的受试者中，md-SCD比sd-SCD具有更高的认知下降风险，为早期识别AD高危个体提供了有价值的参考和便捷工具。
