社区老年人阿尔茨海默病的血液生物标志物和12年肌肉力量轨迹：一项队列研究

IF 13.4 Q1 GERIATRICS & GERONTOLOGY

Lancet Healthy Longevity Pub Date : 2025-05-01 DOI:10.1016/j.lanhl.2025.100715

Alice M Ornago MD , Elena Pinardi MD , Giulia Grande PhD , Martina Valletta MD , Amaia Calderón-Larrañaga PhD , Sarah Andersson MSc , Riccardo Calvani PhD , Anna Picca PhD , Emanuele Marzetti PhD , Prof Bengt Winblad PhD , Claudia Fredolini PhD , Prof Giuseppe Bellelli MD , Davide L Vetrano PhD

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引用次数: 0

摘要

背景：与年龄相关的肌肉功能下降是健康老龄化的主要障碍。我们的目的是研究一组阿尔茨海默病相关生物标志物与肌肉力量的纵向轨迹之间的关联，同时探索认知功能的影响。方法：在这项队列研究中，我们收集了瑞典国家研究在Kungsholmen的老龄化和护理（SNAC-K）的数据，这是一项正在进行的前瞻性研究，包括来自瑞典斯德哥尔摩市中心的60岁及以上的成年人。我们纳入了从基线到第四次随访（2001年3月21日至2016年12月31日）的数据。在无痴呆的社区参与者中测量了7种与阿尔茨海默病相关的血液生物标志物：总tau蛋白、磷酸化tau181 （p-tau181）、磷酸化tau217 （p-tau217）、β淀粉样蛋白40和42、神经丝轻链和胶质纤维酸性蛋白（GFAP）。肌肉力量是通过握力和椅架测试来测量的。线性混合模型用于探索基线阿尔茨海默病相关生物标志物与肌肉力量轨迹之间的关联。结果：基线SNAC-K队列包括3363名个体，其中1953名参与者被纳入我们的分析(平均年龄70.2 [SD 9.1]岁；780[39.9%]名男性，1173[60.1 %]名女性)。在调整后的模型中，p-tau181浓度较高(β /年0.93 [95% CI 0.71 ~ 1.16]；结论：我们的研究结果表明，血液中与阿尔茨海默病相关的生物标志物可能有助于估计老年人肌肉力量的进行性下降，阐明脑病理和认知老化对这种关联的影响。这些与阿尔茨海默病相关的生物标志物可以帮助识别个体，进行早期干预，以预防肌肉减少症。资助：瑞典研究理事会、瑞典卫生和社会事务部以及县议会和市政府。

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Blood biomarkers of Alzheimer’s disease and 12-year muscle strength trajectories in community-dwelling older adults: a cohort study

Background

Age-related muscle function decline is a major impediment to healthy ageing. We aimed to investigate the association between a panel of Alzheimer’s disease-related biomarkers and longitudinal trajectories of muscle strength, while exploring the influence of cognitive function.

Methods

In this cohort study, we gathered data from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K), an ongoing prospective study that includes adults aged 60 years and older, from central Stockholm, Sweden. We included data from baseline to the fourth follow-up (March 21, 2001, to Dec 31, 2016). Seven Alzheimer’s disease-related blood biomarkers were measured in dementia-free, community dwelling participants: total tau, phosphorylated tau181 (p-tau181), phosphorylated tau217 (p-tau217), amyloid β 40 and 42, neurofilament light chain, and glial fibrillary acidic protein (GFAP). Muscle strength was measured through the handgrip strength and chair-stand tests. Linear mixed models were used to explore the association between baseline Alzheimer’s disease-related biomarkers and muscle strength trajectories.

Findings

The baseline SNAC-K cohort included 3363 individuals, of whom 1953 participants were included in our analyses (mean age 70·2 [SD 9·1] years; 780 [39·9%] male and 1173 [60·1%] female participants). In adjusted models, higher concentrations of p-tau181 (β per year 0·93 [95% CI 0·71 to 1·16]; p<0·0001), p-tau217 (β per year 1·31 [1·03 to 1·58]; p<0·0001), neurofilament light chain (β per year 0·76 [0·56 to 0·96]; p<0·0001), and GFAP (β per year 0·37 [0·21 to 0·53]; p<0·0001) were associated with an accelerated decline of chair-stand performance over time. The adjustment for Mini-Mental State Examination (MMSE) score led to the attenuation of these associations. Higher concentrations of p-tau181 (β per year –0·12 [95% CI –0·17 to –0·07]; p<0·0001), p-tau217 (β per year –0·13 [–0·20 to –0·07]; p<0·0001), and neurofilament light chain (β per year –0·05 [–0·09 to –0·001]; p=0·047) were also associated with faster handgrip strength decline, with no attenuation after adjusting for MMSE score. Sex-specific differences were observed, with female participants showing a stronger association between biomarker concentrations and muscle strength decline than male participants, particularly in the chair-stand test.

Interpretation

Our findings suggest that blood Alzheimer’s disease-related biomarkers might help estimate progressive muscle strength decline among older adults, elucidating the influence of brain pathology and cognitive ageing on this association. These Alzheimer’s disease-related biomarkers could aid in identifying individuals for early intervention to prevent sarcopenia.

Funding

The Swedish Research Council, the Swedish Ministry of Health and Social Affairs, and the County Councils and Municipalities.

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来源期刊

Lancet Healthy Longevity GERIATRICS & GERONTOLOGY-

CiteScore

16.30

自引率

2.30%

发文量

192

审稿时长

12 weeks

期刊介绍： The Lancet Healthy Longevity, a gold open-access journal, focuses on clinically-relevant longevity and healthy aging research. It covers early-stage clinical research on aging mechanisms, epidemiological studies, and societal research on changing populations. The journal includes clinical trials across disciplines, particularly in gerontology and age-specific clinical guidelines. In line with the Lancet family tradition, it advocates for the rights of all to healthy lives, emphasizing original research likely to impact clinical practice or thinking. Clinical and policy reviews also contribute to shaping the discourse in this rapidly growing discipline.