Alzheimer's & Dementia · Jul 8, 2026

Identifying populations with faster cognitive decline using blood-based biomarkers

By Pike JR, Liu Y, Chisolm T et al.

INTRODUCTION: Identifying individuals who undergo cognitive decline is vital to the success of prevention trials that aim to slow cognitive decline. Yet, the benefits of using blood-based biomarkers of neurodegeneration, as well as amyloid and tau, to enrich population-based prevention trials have not been quantified. METHODS: The association of thresholds of Quanterix single molecule array (SiMoA) assays with subsequent change in cognition was estimated in the Atherosclerosis Risk in Communities cohort (N = 1826) using linear mixed effects models, validated in the Multi-Ethnic Study of Atherosclerosis cohort (N = 383), and extended to Alamar Nucleic acid Linked Immuno-Sandwich Assay (NULISA) assays in the Aging and Cognitive Health Evaluation in Elders cohort (N = 552). RESULTS: Elevated plasma biomarker levels identified dementia-free older adults with faster cognitive decline. By selecting participants with Quanterix SiMoA measurements of neurofilament light > 30.65 pg/mL, the sample size needed to detect a 33% reduction in cognitive decline in a clinical trial decreased by 57%. DISCUSSION: Clinical trials can use plasma biomarkers as a screening tool to increase statistical power.

doi.org/10.1002/trc2.70289Open accessPubMed 42421822Biomarkers