Abstract

Introduction: Blood biomarkers forAlzheimer’s disease (AD) are the future of AD risk assessment. The aim of thisstudy was to determine the association between plasma- measured phosphorylatedtau (p-tau181), glial fibrillary acidic protein (GFAP), and neu- rofilamentlight (NfL) levels and risk of clinical AD incidence with consideration to theimpact of cardiovascular health.

Methods: Within a community-based cohort,biomarker levels were measured at base- line using single molecule arraytechnology in 768 participants (aged 50–75) followed over 17 years.Associations among biomarkers and AD, vascular dementia, and mixed dementiaincidence were assessed.

Results: GFAP was associated with clinicalAD incidence even more than a decade before diagnosis (9–17 years), whilep-tau181 and NfL were associated with more intermediate AD risk (within 9years). Significant interaction was detected between cardiovascular health andp-tau181/NfL.

Discussion: GFAP may be an early ADbiomarker increasing before p-tau181 and NfL and the effect modifying role ofcardiovascular health should be considered in biomarker risk stratification.