Plasma Aβ42/Aβ40 and p‐tau181 are associated with clinical progression in amnestic mild cognitive impairment: An 8‐year longitudinal study

Abstract Background Previous studies indicated that blood‐based biomarkers could predict cognitive decline in Alzheimer’s disease (AD) continuum. Method Two hundred and fifty‐one participants with amnestic mild cognitive impairment (aMCI) from the Shanghai Memory Study were followed up for a maximum of 8 years. Baseline blood biomarkers were measured with the single‐molecule array (Simoa) platform. Multipoint clinical diagnosis and domain‐specific cognitive functions were assessed to investigate the longitudinal relationship between blood biomarkers and clinical AD progression. Result Participants with high‐risk plasma Aβ42/Aβ40 (A) and p‐tau181 (T) level demonstrated the highest probability of incident AD (HR 5.54, 95% CI 2.99‐10.27), and the most dramatic decline in global cognition, attention, executive function, visuospatial function, and language. Comparing to young‐old participants, the old‐old ones with low‐ and moderate‐risk AT showed higher AD risks (HR 3.70, 95% CI 1.16‐11.81; HR 3.15, 95% CI 1.37‐7.26), and faster cognitive deterioration. Conclusion The results supported the use of plasma Aβ42/Aβ40 and p‐tau181 as accessible and feasible indicators of AD progression and the long‐term cognitive deterioration, especially in patients with older age.