DBS-based Biomarkers of Neurodegeneration predict Cognitive Decline and Dementia Seven Years Ahead in a Large Population-Based Sample

INTRODUCTION: It is unknown whether biomarkers of neurodegeneration collected from dried blood spots (DBS) in large-scale population settings are useful in predicting cognitive decline many years later. METHODS: In 2015, we collected DBS of 13,679 individuals aged 58 and older. All DBS were assayed for ApoE4 protein, and a smaller subsample for pTau217, GFAP, and NfL. In 2022, we obtained detailed cognition measures for 6,523 respondents. Regression analyses tested the likelihood of cognitive impairment as a function of biomarker levels. RESULTS: Respondents with ApoE4 detection have worse cognitive performance seven years later as measured by six different cognitive performance measures (p