Plasma NfL Levels Across Cognitive Stages and the Impact of Comorbidities in a Thai Cohort
Bibliographic record
Abstract
Abstract Background Elevated plasma neurofilament light chain (NfL) is a promising biomarker for dementia diagnosis. However, it has also been reported to be associated with age, body mass index (BMI), and comorbidities such as diabetes, hypertension, chronic kidney disease (CKD), stroke, and cardiovascular diseases. This study aimed to investigate the relationship between plasma NfL levels, cognitive performance, and activities of daily living (ADL) in a Thai population, as well as the comorbidities influencing NfL levels. Method A pilot study was conducted with 48 participants categorized into normal cognition ( n = 4), mild cognitive impairment (MCI)( n = 18), and dementia ( n = 26) groups. Plasma NfL levels were analyzed using Single Molecule Arrays (SiMoA) technology. Statistical analyses, including Mann‐Whitney U Test and Spearman's rho correlations, were used to examine associations between NfL levels and other variables. Result The mean age of participants was 70.8±12.0 years, and 58.3% were female. Median plasma NFL levels were significantly higher ( p <0.05) in the dementia group (44.3, IQR45.9) compared to the MCI (18.7, IQR13.9) and normal cognition groups (8.6, IQR15.8). Higher NFL levels were significantly associated with lower cognitive scores, including Thai Mental State Examination scores (r=‐0.58, p <0.001) and Montreal Cognitive Assessment scores (r=‐0.55, p <0.001). They also correlated with poorer function, as measured by the sum of basic and instrumental ADL scores, and Clinical Dementia Rating scale‐sum of boxes (r=0.61 and 0.64, respectively, p <0.001). Plasma NFL levels were significantly correlated with serum albumin (r=‐0.37, p = 0.028) and BMI ( r =‐0.37, p = 0.023). Age and comorbidities, including diabetes, hypertension, dyslipidemia, CKD, cardiovascular and cerebrovascular disease, levels of blood urea nitrogen, creatinine, liver enzymes, lipid profiles, and thyroid functions, did not significantly influence NfL concentrations. However, higher creatinine (r=0.31, p = 0.051) and a history of CKD ( p = 0.054) showed a trend toward an associate with elevated plasma NfL levels. Conclusion In our pilot study, plasma NfL levels are significantly associated with dementia stages, ADL, serum albumin, and BMI and showed a trend toward an associated with renal dysfunction. The interplay between systemic health and NfL levels underscores the need for comorbidity assessments in dementia research, laying the foundation for future studies to validate NfL and expand its applicability across diverse populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".