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Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies
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Biomarkers.

Jeremy M Gu1, Laisze Lee2, Dana L Tudorascu2

  • 1University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

The NIH Toolbox Cognition Battery (NIHTB-CB) shows promise in detecting early Alzheimer's disease (AD) pathology. Cortical thickness (CT) and plasma p-tau217 are key indicators linked to cognitive function in older adults.

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Area of Science:

  • Neuroscience
  • Biomarker Research
  • Cognitive Aging

Background:

  • The NIH Toolbox Cognition Battery (NIHTB-CB) is increasingly used in Alzheimer's disease (AD) research to assess cognitive abilities.
  • However, its correlation with AD biomarkers, especially in preclinical stages, remains under-investigated.

Purpose of the Study:

  • To examine the relationship between NIHTB-CB cognitive scores and novel plasma and imaging biomarkers in non-demented older adults.
  • To assess the sensitivity of NIHTB-CB to early AD-related pathology.

Main Methods:

  • 258 participants underwent clinical classification, [11C] PiB-PET, MRI for cortical thickness (CT), and plasma biomarker analysis (BD-tau, p-tau217, p-tau181, p-tau231, Aβ42/40, GFAP, NfL).
  • Linear regression models analyzed associations between NIHTB-CB scores and biomarkers, controlling for covariates.
  • Analyses were performed on the whole sample and in cognitively normal (CN) and CN+ subsets.

Main Results:

  • Plasma p-tau217 and cortical thickness (CT) demonstrated the strongest associations with NIHTB-CB scores across the sample.
  • CT composite scores were significantly linked to fluid and total cognition composite scores.
  • In the CN subset, lower CT, higher PiB-PET SUVR, and higher p-tau217 correlated with worse fluid cognition, while higher p-tau181/231 correlated with better crystallized cognition.

Conclusions:

  • NIHTB-CB effectively reveals cognition-biomarker relationships, including plasma biomarkers, even in cognitively normal individuals.
  • Cortical thickness is a critical marker reflecting neurodegeneration's impact on cognition.
  • Findings support the NIHTB-CB's utility in identifying early cognitive changes associated with AD pathology.