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Alzheimer's & dementia : the journal of the Alzheimer's Association
Published

Impact of racialization on neuroimaging and plasma biomarkers of Alzheimer's disease

Authors

Alexandra Gogola, Xuemei Zeng, Lilcelia A Williams, Theresa Chapple-McGruder, Anum Saeed, Brian J Lopresti, Beth Snitz, Dana Tudorascu, Davneet Minhas, Milos D Ikonomovic, Julia Kofler, Cristy Matan, Tharick A Pascoal, Howard Aizenstein, Henrik Zetterberg, Kaj Blennow, Oscar Lopez, Victor L Villemagne, Thomas K Karikari, Ann D Cohen

Abstract

Alzheimers Dement. 2025 Jul;21(7):e70463. doi: 10.1002/alz.70463.

ABSTRACT

INTRODUCTION: Given the predominance of imaging and plasma biomarkers in Alzheimer's disease observational studies and clinical trials, it is critical to understand the differences between these biomarkers across racialized groups.

METHODS: A total of 260 older adults without dementia racialized as Black and/or African American (AA) and non-Hispanic white (NHW), ranging in age from 50 to 90 years (68.8 ± 9.1 years), were evaluated for differences in plasma amyloid-β (Aβ) 42/Aβ40, p-tau181, p-tau217, p-tau231, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) as well as Aβ positron emission tomography (PET) and magnetic resonance (MR) imaging-derived cortical thickness using Mann-Whitney U tests and analysis of covariance (ANCOVA).

RESULTS: Both Mann-Whitney tests and ANCOVA found significant differences between groups racialized as AA or NWH with respect to global 11[C]-Pittsburgh Compound B (PiB) standardized uptake value ratio (SUVR), cortical thickness values, p-tau181, and p-tau231 values (p < 0.05).

DISCUSSION: Racialization should be given more consideration in AD clinical research, particularly when biomarker results are used for inclusion or exclusion criteria for clinical trials and qualification in clinical practice.

HIGHLIGHTS: Global 11[C]-Pittsburgh compound B (PiB) standardized uptake value ratio (SUVR), cortical thickness, p-tau181, and p-tau231 differed between groups Differences were unaffected by age, sex, apolipoprotein E *4 (APOE*4), education, and Mini-Mental State Examination (MMSE) score Racialization needs more consideration in Alzheimer's disease clinical research Additional work is needed to understand the sources of biomarker differences.

PMID:40631440 | DOI:10.1002/alz.70463

UK DRI Authors

Profile picture of Henrik Zetterberg

Prof Henrik Zetterberg

Group Leader

Pioneering the development of fluid biomarkers for dementia

Prof Henrik Zetterberg