Physical and biopsychosocial frailty, cognitive phenotypes, and plasma biomarkers for Alzheimer's disease in Chinese older adults: A population-based study

IF 13 1区医学 Q1 CLINICAL NEUROLOGY

Alzheimer's & Dementia Pub Date : 2025-05-21 DOI:10.1002/alz.70303

Xunyao Tian, Min Zhu, Yixun Ma, Nan Wang, Lin Shi, Cuicui Liu, Heng Zhang, Na Tian, Lin Song, Shi Tang, Lin Cong, Yongxiang Wang, Davide L Vetrano, Tingting Hou, Yifeng Du, Chengxuan Qiu

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Abstract

INTRODUCTION

We sought to examine the associations of physical frailty (PF) and biopsychological frailty (BF) with dementia and mild cognitive impairment (MCI) among Chinese older adults and further to explore neuropathological mechanisms underlying the associations.

METHODS

This population-based cross-sectional study included 5149 participants in the MIND-China baseline examination (2018); of these, we measured plasma amyloid-β (Aβ), neurofilament light chain (NfL), and total tau in 1371 persons and phosphorylated tau 217 (p-tau217) and glial fibrillary acidic protein (GFAP) in 3387 persons.

RESULTS

PF and BF were significantly associated with increased likelihoods of dementia, Alzheimer's disease (AD), vascular dementia (VaD), and MCI. PF was significantly correlated with increased plasma p-tau217, GFAP, and NfL, and reduced Aβ42/Aβ40 ratio; BF was related to higher plasma total tau and NfL and lower Aβ42/Aβ40 ratio. PF in combination with demographics performed excellent in differentiating dementia from non-dementia (area under the curve [AUC] = 0.83).

DISCUSSION

PF and BF are potential clinical biomarkers for dementia and MCI in older adults. Alzheimer's pathology, neuroinflammation, and neurodegeneration may underlie their associations.

Highlights

Physical (PF) and biopsychosocial frailty (BF) were strongly associated with dementia and mild cognitive impairment (MCI) in rural Chinese older adults.
Frailty, especially PF, was associated with increased plasma phosphorylated tau 217 (p-tau217), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL) and a reduced plasma amyloid-β (Aβ)42/Aβ40 ratio.
Alzheimer's pathology, neuroinflammation, and neurodegeneration may underlie the associations of frailty with dementia.
PF, in combination with demographic factors, performed excellent (area under the curve [AUC] = 0.83) in differentiating dementia from non-dementia in rural older adults.

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中国老年人阿尔茨海默病的生理和生物心理社会脆弱性、认知表型和血浆生物标志物：一项基于人群的研究

我们试图研究中国老年人身体虚弱（PF）和生物心理虚弱（BF）与痴呆和轻度认知障碍（MCI）的关联，并进一步探讨这些关联背后的神经病理学机制。方法：这项基于人群的横断面研究纳入了MIND-China基线检查（2018）的5149名参与者；其中，我们测量了1371人的血浆淀粉样蛋白-β (Aβ)、神经丝轻链（NfL）和总tau蛋白，以及3387人的磷酸化tau217 （p-tau217）和胶质纤维酸性蛋白（GFAP）。结果PF和BF与痴呆、阿尔茨海默病（AD）、血管性痴呆（VaD）和MCI的可能性增加显著相关。PF与血浆p-tau217、GFAP和NfL升高、a - β42/ a - β40比值降低显著相关；BF与血浆总tau和NfL升高以及a - β42/ a - β40比值降低有关。PF结合人口统计学在区分痴呆和非痴呆方面表现出色（曲线下面积[AUC] = 0.83）。PF和BF是老年人痴呆和轻度认知障碍的潜在临床生物标志物。阿尔茨海默病病理、神经炎症和神经退行性变可能是它们之间联系的基础。中国农村老年人的生理（PF）和生物心理社会脆弱性（BF）与痴呆和轻度认知障碍（MCI）密切相关。脆弱，尤其是PF，与血浆磷酸化tau217 （p-tau217）、胶质纤维酸性蛋白（GFAP）和神经丝轻链（NfL）增加以及血浆淀粉样蛋白-β (a β)42/ a β40比值降低有关。阿尔茨海默病的病理、神经炎症和神经退行性变可能是虚弱与痴呆之间联系的基础。结合人口统计学因素，PF在区分农村老年人痴呆与非痴呆方面表现优异（曲线下面积[AUC] = 0.83）。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.