ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2025
Prognostic value of plasma glial fibrillary acidic protein in cognitively unimpaired older adults: Results from the A4 study.
Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed.
- Alzheimer's blood-based biomarkers, incident dementia, and interactions with age, APOE status, and hormone therapy.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Trial
- Article
- Analytical Performance and Evaluation in Clinical Cohorts of a Fully Automated Immunoassay for Plasma Glial Fibrillary Acidic Protein.Diagnostics (Basel, Switzerland) · 2026Article
- MethylCog predicts six-year cognitive ability beyond blood-based ADRD biomarkers.medRxiv : the preprint server for health sciences · 2026Article
- [Progress on prognostic assessment methods for mild cognitive impairment].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2026Review
- Comparative analyses of Alzheimer's disease blood biomarkers and cognitive domains.medRxiv : the preprint server for health sciences · 2026Article
- Predictive Biomarkers for Asymptomatic Adults: Opportunities, Risks, and Guidance for General Practice.Diagnostics (Basel, Switzerland) · 2026Review
- Anemia, iron deficiency, and blood biomarkers for Alzheimer disease: clinical interpretation and dementia risk stratification.Frontiers in nutrition · 2026Review
- Prognostic value of plasma glial fibrillary acidic protein in cognitively unimpaired older adults: Results from the A4 study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Comparative analyses of Alzheimer's disease blood biomarkers and cognitive domains.Alzheimer's & dementia (Amsterdam, Netherlands)Article
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Abstract
introductionPlasma glial fibrillary acidic protein (GFAP), a marker of astrocytic activation, has been linked to Alzheimer's disease; however, its prognostic value in cognitively unimpaired (CU) individuals remains unclear.
methodsWe included 949 CU older adults from the A4 preclinical AD trial and its companion LEARN cohort. Baseline plasma GFAP was measured, and associations with cognitive decline (Preclinical Alzheimer's Cognitive Composite [PACC]), Clinical Dementia Rating (CDR) progression, and imaging biomarkers were assessed over 240 weeks.
resultsBaseline plasma GFAP was higher in females and in A4 (amyloid-positive) versus LEARN (amyloid-negative) participants. Cross-sectionally, elevated GFAP was associated with lower cognitive performance and greater amyloid burden. Longitudinally, higher GFAP predicted faster cognitive decline, increased risk of CDR progression, AD-related cortical atrophy, and amyloid conversion, with stronger effects in females. DISCUSSION: Plasma GFAP is a prognostic biomarker in CU older adults, predicting cognitive and biological changes, with stronger associations observed in females, highlighting a possible sex-specific vulnerability. HIGHLIGHTS: Elevated plasma glial fibrillary acidic protein (GFAP) predicted faster cognitive decline measured by Preclinical Alzheimer's Cognitive Composite (PACC). GFAP was associated with increased risk of progression to mild cognitive impairment. GFAP predicted conversion to amyloid positivity in amyloid-negative subjects. Higher baseline GFAP was associated with cortical atrophy in Alzheimer's disease (AD) -signature areas. Associations of GFAP with cognition and AD biomarkers were stronger in females.
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